Positive Or Negative Tilt Table Test result?

Posted by yellowdoggirl @yellowdoggirl, Sep 11 6:12am

Is this a"positive" result? Does it indicate a dysautonomia because HR remained stable in the face of a precipitous BP drop?
3 days ago I had a tilt table test. After 20 minutes standing, I was given sublingual nitroglycerin. Within 5 minutes my BP dropped to 64/37, heart rate stayed around 64. Room was going black, I heard, "Let's lie her down," and was almost immediately back to consciousness, although kind of dopey.
My EP and his office are singularly uncommunicative, not responding to my EHR messages yet after 3 days.
I have been reading and reading, searching for an answer.
I have an ILR, paroxysmal AFib, tachy-brady, labile hypertension which is quite stable in a healthy range, lightheaded most of the time, dizzy with BP drops, some other dysautonomia symptoms, and 3 autoimmune things.
Taking 12.5 mg metoprolol. More sends HR into 40's, 50's otherwise. I exercise at least 6 days/week, mostly swim so I can't fall.
What does this mean?
Thank you for the help I can't get from the doctor!

Hello @yellowdoggirl. I can see how you would feel frustrated left translating your results.

Reference info: "The result is positive if your blood pressure decreases and you feel dizziness or faint during the test. The result is negative if your heart rate increases only slightly, your blood pressure doesn't drop significantly, and you don't have signs or symptoms of fainting."

– Tilt table test – Mayo Clinic:
https://www.mayoclinic.org/tests-procedures/tilt-table-test/about/pac-20395124
Did you take the test while on any of your medication?

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@amandajro

Hello @yellowdoggirl. I can see how you would feel frustrated left translating your results.

Reference info: "The result is positive if your blood pressure decreases and you feel dizziness or faint during the test. The result is negative if your heart rate increases only slightly, your blood pressure doesn't drop significantly, and you don't have signs or symptoms of fainting."

– Tilt table test – Mayo Clinic:
https://www.mayoclinic.org/tests-procedures/tilt-table-test/about/pac-20395124
Did you take the test while on any of your medication?

Jump to this post

Thank you so much@amandajro!
Yes, as instructed I took levothyroxine and Omeprazole about 5AM, then (I think) B12, crestor Eliquis, and maybe Plaquenil.
No coffee! Or anything else.
I don't remember very well. The test was at 11. When I got home in the early afternoon, I took the rest and ate.
The metoprolol I take at bedtime.
Did I do the wrong thing?
Thank you again!

REPLY
@amandajro

Hello @yellowdoggirl. I can see how you would feel frustrated left translating your results.

Reference info: "The result is positive if your blood pressure decreases and you feel dizziness or faint during the test. The result is negative if your heart rate increases only slightly, your blood pressure doesn't drop significantly, and you don't have signs or symptoms of fainting."

– Tilt table test – Mayo Clinic:
https://www.mayoclinic.org/tests-procedures/tilt-table-test/about/pac-20395124
Did you take the test while on any of your medication?

Jump to this post

One more question: wouldn't anyone's blood pressure drop after the nitroglycerine??

REPLY
@yellowdoggirl

Thank you so much@amandajro!
Yes, as instructed I took levothyroxine and Omeprazole about 5AM, then (I think) B12, crestor Eliquis, and maybe Plaquenil.
No coffee! Or anything else.
I don't remember very well. The test was at 11. When I got home in the early afternoon, I took the rest and ate.
The metoprolol I take at bedtime.
Did I do the wrong thing?
Thank you again!

Jump to this post

Hi, i have been taking thyroid medicine (synthroid) since I was 17 years old and I’m 81 now. Endocrinologists have always told me not to eat, drink anything but water for one hour after I take my thyroid and to wait at least four hours before I take any calcium. So I don’t know about your other medications but check with your doctor.

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Hooray!!
I am so happy! The APRN called and I was able to get my questions answered.
Apparently, if a person's blood pressure falls, the autonomic nervous system is supposed to increase the heart rate to compensate. Mine didn't.
That is, from what I read, a kind of dysautonomia.
The remedy is a drug if higher salt and more hydration don't work. If that fails, then maybe a pacemaker, which she told me never works very well.
Dysautonomias are more common in people with celiac disease and other autoimmune diseases, all of which I have.
I am so happy to have an explanation.
We'll see where we go from here, but I am satisfied at the moment that she responded and that I have an understandable explanation.
Thank you all for your help!
It is so good to have a community of knowledgeable people who are willing to help!

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