This film will show you what to expect if you are having a tilt test.
My name is Pak Au.
I live in Kingston upon Thames.
I am 73 years old.
I'm here because I have chest pains and blackouts.
We'll ask you a few questions about the symptoms you've been having.
Hi.
I'm Siobhan.
I'm a specialist cardiac nurse.
The tilt test is for patients who feel dizzy or have blackouts.
It's a test that involves the patient being tilted to a standing position,
usually somewhere between 60 or 90 degrees.
We try and see if we can get the patient to feel some of the symptoms,
while we monitor their blood pressure and their heart rate.
Then we can see if there is any association between the two.
We put the lights down, make sure it's nice and dim and quiet
because we don't want to stimulate the patient at all
to make sure the test is really valid.
I know I'm in safe hands.
In fact, I am looking forward to the test.
Overall a tilt test appointment is usually just over an hour
but the actual tilt test itself can take anything
between 15 minutes and 45 minutes, tilted in the upright position.
We get them to put a gown on their top half.
If you're a lady, you leave your bra on.
Then we attach three electrodes to the skin on the chest
to record the heart rhythm.
We put a blood pressure cuff on their arm.
We put another device on their finger to measure blood pressure.
There we go.
OK, so we're going to tilt you up now.
It should feel a bit weird, but it shouldn’t be unpleasant,
We tilt up for 20 minutes.
Just relax your arm.
That's it.
- Are you OK there?
- I'm fine.
Fantastic.
Sometimes we encourage people to carry on with the test,
Even if they’re getting some symptoms if we feel we haven't enough answers
in terms of blood pressure and heart rate
to draw conclusions on what may be causing the symptoms.
- Any dizziness?
- No.
Am I supposed to have some?
No, no, no.
You just tell us how you're feeling.
But the patient is always in control.
If they want to stop, then that's always fine.
After 20 minutes, if they're feeling OK and nothing major has happened,
we'll give them a spray of a medication called GTN.
If you open your mouth and lift your tongue up.
That's it.
There you go.
All done.
It makes the heart rate a bit faster and the blood pressure a bit lower.
It's an extra stimulation, a little push
to try and get them to feel some symptoms.
Then it's another 15 minutes
and that's the end of the test and we lie them flat.
If the patient Has had a positive tilt test,
then they may feel a bit groggy or unwell after the test.
- Are you OK?
- Yes, yes.
We usually give them a few minutes to recover
and then we'll go through the results with them.
It's a good idea to bring someone with you when you have a tilt test,
so if you do feel unwell, someone can take you home and look after you.
I was expecting some physiological change in me,
but nothing seemed to have happened.
You said during the test you weren't feeling any symptoms?
- I didn't, no.
- Nothing at all.
But we did get some useful information.
No matter what the result of a tilt test,
we always send the results back to the referring doctor.
In Mr Au's case,
as he didn't have the symptoms he's been complaining of,
we'll call it inconclusive,
but it's all helpful information that will help towards a diagnosis.
I was treated well.
Yes, I'm pleased to have had the test.
I hope I will plod on for a few more years yet!
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