What is the Head-up Tilt Test with Isoprenaline?

This is a test which is used to find out the cause of your fainting spells and dizziness and enable us to check how your blood pressure and heart rate responds to standing. The test involves being tilted, always with the head up, for a period of time. Heart rate, blood pressure and other symptoms are closely monitored.

What will happen during the test?

• A nurse or doctor will be with you at all times. The Head-up Tilt test with Isoprenaline lasts about one hour.
• During the test you will lie on a special bed (a tilt bed) that has a foot board and a motor which we control
• We will ask you to change into a hospital gown. The nurse will connect you to an ECG to monitor your heart rate, and a blood pressure monitor.
• You will be awake and asked to lie quietly and to keep your legs still.
• For this test you will need an intravenous line inserted into your arm or your hand. The Isoprenaline will be infused through this line into your bloodstream.
• This test involved being tilted upright (always head up) for a period of time. Blood pressure and heart rate are recorded during the test. The infusion of Isoprenaline is monitored very carefully.
• If the test is negative, the doctor may decide to refer you for other tests. These could include a 24-hour blood pressure monitor, 24-hour heart rate monitor, a scan of your heart or a monitor that you wear for a few weeks to monitor your heart rate. We will explain these to you at the time.
• If the test is positive, the doctor will discuss the diagnosis with you and inform you about the treatment for this.

What is Isoprenaline?
Isoprenaline is one of a group of drugs called ‘inotropes’. These drugs act to speed up the heart and raise the blood pressure. By giving you Isoprenaline, we increase the chance that the tilt test will provoke some causes of fainting and dizziness. Isoprenaline is a short-acting drug given intravenously (through a line into your vein). It is only in your system for a few minutes after the infusion is stopped.

How will I feel?
 

• With this test, we are trying to reproduce your symptoms in a safe environment.
• Isoprenaline is a very short-acting drug and will be out of your system very quickly.
• You may feel no symptoms at all, or you may experience feelings of nervousness, feeling jittery or a feeling that your heart is beating faster and stronger. These are all symptoms of the medication and will go away as the medication wears off.
• Please tell the doctor and nurse how you are feeling during the test.

What are the benefits of having the test?

• This test will help to establish the cause of your falls, blackouts and/or dizziness and will help to guide the doctors to the right treatment for you. It may indicate that you need further tests.

What are the risks or side effects of the test?

• With this test we may reproduce symptoms of dizziness, pre-syncope or syncope. Syncope is the medical term for loss of consciousness. These symptoms will go away once you lie down. You may feel drained afterwards, similar to the symptoms that you experience at home.
• As mentioned above, you may experience symptoms of shaking, flushing, nausea and vomiting or you may experience some chest pain. These are all side effects of this medication and will resolve as soon as the Isoprenaline is stopped.

What happens if I don’t have the test?
We would not recommend this test unless we thought it would help to find the cause of your symptoms. If you do not have the test, it may reduce the chance of us discovering the cause of your symptoms and recommending the best treatment to help you.

What happens next?

• If you have any symptoms, we will let you rest until you feel fully recovered.
• The doctor will then discuss your test and inform you of the findings.
   

We hope that this leaflet has been helpful.
 

If you have any questions or are worried about the tests, please ask the doctor
or nurse, who will explain them to you.
Contact Falls and Syncope Service
Telephone 0191 282 5237
Hours Monday to Friday 9.00am – 5.00pm