Key result
Head-up tilt testing remains a valuable clinical asset for assessing syncope of unknown origin, improving the understanding of pathophysiology and the care of syncopal patients.
Head-up tilt testing remains a valuable clinical tool for the evaluation of syncope and autonomic dysfunction, as supported by professional practice guidelines.
Supports tilt testing for unexplained syncope; leaves open need for randomized trials before changing practice.
Head-up tilt test (TT) has been used for >50 years to study heart rate/blood pressure adaptation to positional changes, to model responses to haemorrhage, to assess orthostatic hypotension, and to evaluate haemodynamic and neuroendocrine responses in congestive heart failure, autonomic dysfunction, and hypertension. During these studies, some subjects experienced syncope due to vasovagal reflex. As a result, tilt testing was incorporated into clinical assessment of syncope when the origin was unknown. Subsequently, clinical experience supports the diagnostic value of TT. This is highlighted in evidence-based professional practice guidelines, which provide advice for TT methodology and interpretation, while concurrently identifying its limitations. Thus, TT remains a valuable clinical asset, one that has added importantly to the appreciation of pathophysiology of syncope/collapse and, thereby, has improved care of syncopal patients.
No takes yet. Share an insight, caveat, or question.
Sutton et al. (2021) conducted a review in Syncope. Head-up tilt test was evaluated. Head-up tilt testing remains a valuable clinical asset for assessing syncope of unknown origin, improving the understanding of pathophysiology and the care of syncopal patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: