The fainting patient: value of the head-upright tilt-table test in adult patients with orthostatic intolerance

THE HEAD-UPRIGHT TILT-TABLE (HUT) TEST IS USED primarily for the investigat ion of or thostatic symptoms. Although this test is frequently the gold sta ndard for the evaluation of neurocardiogenic syncope, dysautonomia and post ural orthostatic tachycardia syndrome, there is a debate over its diagnosti c value and method. The authors review the physiologic basis of the HUT tes t, the method, patterns of response, indications and contraindications, and diagnostic validity. Despite its limitations, the HUT test is useful in pa tients with a variety of clinical manifestations induced by orthostatism. i t is most useful in documenting objective measures of orthostatic hypertens ion that cannot be obtained in a clinical setting.