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Syncope pp 279-289 | Cite as

How to: Tilt-Table Testing

  • Michele Brignole
  • David G. Benditt
Chapter

Abstract

On moving from supine to erect posture there is a large gravitational shift of blood away from the chest to the distensible venous capacitance system below the diaphragm. This shift is estimated to total ½–1 L of thoracic blood with most of the volume shift occurring in the first 10 s of upright posture. In addition, with prolonged standing, the high capillary transmural pressure in dependent parts of the body causes filtration of protein-free fluid into the interstitial spaces. It is estimated that this results in about a 15–20% (700 ml) decrease in plasma volume in 10 min in healthy humans. As a consequence of this gravitationally induced blood pooling and the superimposed decline in plasma volume, the return of venous blood to the heart is reduced; the result is rapid diminution of cardiac filling pressure and a consequent decrease in stroke volume. However, normally, despite decreased cardiac output, hypotension is prevented by compensatory vasoconstriction of the resistance and the capacitance vessels in the splanchnic, musculo-cutaneous, and renal vascular beds.

Keywords

Tilt Testing Venous Cannulation High Positivity Rate Good Diagnostic Accuracy Cardiac Filling Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  1. 1.Dipartimento di Cardiologia, Centro AritmologicoOspedali del TigullioLavagnaItaly
  2. 2.Cardiac Arrhythmia CenterMedical School, University of MinnesotaMinneapolisUSA

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