TILT TABLE TEST

Name: Daniel Justine Sy July 9, 2018

Age/Gender: 23 Male

Requesting physician: Dr. Louie Tan

Indication: Syncope

Baseline BP: 110/70 HR: 88 ECG: Sinus Rhythm

Carotid massage:

Right: BP 100/60 HR 78 ECG: Sinus Rhythm

Left: BP 100/60 HR: 80 ECG: Sinus Rhythm

TILT:

TIME BLOOD PRESSURE HEART RATE ECG

1 minute 110/70 91 Sinus Rhythm
3 minutes 120/80 89 Sinus Rhythm
6 minutes 120/90 99 Sinus Rhythm
9 minutes 110/80 95 Sinus Rhythm
12 minutes 110/80 96 Sinus Rhythm
15 minutes 110/80 103 Sinus Tachycardia
18 minutes 120/80 94 Sinus Rhythm
21 minutes 110/80 96 Sinus Rhythm
24 minutes 110/70 97 Sinus Rhythm
27 minutes 110/70 91 Sinus Rhythm
30 minutes 110/70 96 Sinus Rhythm

Pharmacologic provocation:

TIME BLOOD PRESSURE HEART RATE

1 minute 110/80 92 sinus rhythm
3 minutes 100/70 103 sinus tachycardia
6 minutes 120/90 118 sinus tachycardia
12 minutes 80/60 62 sinus rhythm
Ongoing Fast Drip PNSS 90/60 65 sinus rhythm
15 minutes 90/60 72 sinus rhythm
Recovery 100/70 79 sinus rhythm
Procedure:

Patient was in a post absorptive state. Carotid massage was done on right and left carotid which did not
result in significant change in heart rate and blood pressure. No symptoms reported.

Patient was tilted upright 700 for 30 minutes or until endpoint was reached. During tilt, there were no
significant changes in heart rate nor blood pressure. No symptoms reported.

Pharmacologic provocation was done with 5mg sublingual nitrate and the tilt extended for 15 minutes.
After 3 and 6 minutes of giving 5mg sublingual nitrate, the patient had tachycardia ranging from 103-120 beats per
minute. After 12minutes of administration of nitrate, the patient had lightheadedness and developed near syncope
with associated hypotension and sudden dropped of heart rate (BP 80/60 mmhg and heart rate as lows as of 62
beats per minute). Patient was given with fast drip of 200-300cc on PNSS. Patient was then recovered after 1minute
and had stable vital signs.

Conclusion:

Positive Tilt Table Test for Vasovagal Syncope

Reda A. So, M.D.

Cardiovascular Fellow

Louie Tan, M.D.

Cardiovascular Consultant