Head-up tilt test

What is a head-up tilt test (HUTT)?

A HUTT is used to diagnose Vasovagal Syncope (dizziness and fainting). You will be required to stay in a virtually standing position (60 degrees) for up to 35 minutes. There are normally no needles involved in this test.

Why do I need to have this test?

Your doctor has requested that you have this simple non-invasive test in order to try and find the reason why you have been feeling dizzy or have been fainting.

Preparing for the test

Should I eat normally before the test?

You are advised to have a just light meal (breakfast or lunch) at least a couple of hours beforehand.

What should I wear when I attend for my test?

Please wear something comfortable that allows access to your arms and your chest. Please bring some comfortable shoes or slippers.

What happens during the test?

You will be expected to stand in a slightly reclined position, supported by a backrest, for up to 35 minutes whilst your heartbeat and blood pressure are monitored. If there has been no change after 20 minutes you will have 1-2 sprays (400-800 mcg) of GTN (a nitrate that dilates your blood vessels). You will then need to stay in the same position for a maximum of 15 minutes.

Who carries out the test?

The test is supervised by a Cardiac Physiologist. A doctor may be present during parts of the test and is immediately available throughout the test.

Will I experience any discomfort or side effects?

There is no pain associated with a HUTT. You may feel some pressure from the blood pressure monitoring equipment as this squeezes one of your arms and one of your fingers.

If you are given GTN it may cause a headache, which should dissipate quite quickly on its own. Also during the test you may experience your usual symptoms.

Is there any risk associated with this test?

These tests are carried out routinely and widely throughout the world. Serious complications have been extremely unusual.

A fall in blood pressure and the heart slowing or stopping for a brief period occurs commonly and trying to induce this is the whole point of the test.

What will happen if I do not want to have this test?

If you do not have this test we will not be able to pass important diagnostic information to the doctors. This may affect the medical treatment that you receive.

After the test

What happens after the test?

You may continue to feel dizzy or light headed for a little while after the test. If you have experienced your symptoms during the test, we will continue to monitor you until you are feeling back to normal.

What about travel after the test?

It is preferable for someone to drive you, or at least accompany you home.

When/how will I receive the results of the test?

The doctor who was present during the test will discuss the results with you at your next appointment.

Further information and references

www.stars.org.uk/patient-info/diagnosis/tilt-test [Last Accessed September 2010]

NHS Constitution. Information on your rights and responsibilities. Available at www.nhs.uk/aboutnhs/constitution

If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.

© North Bristol NHS Trust. This edition published September 2019. Review due September 2021 NBT002356

Head-up tilt test