kallistuskoetta

Kallistuskoetta, known in English as the tilt-table test, is a diagnostic procedure used primarily to evaluate unexplained syncope (fainting) and autonomic function. The test aims to reproduce symptoms by changing the patient’s posture under controlled conditions, while monitoring cardiovascular responses.

Procedure and variants: The patient lies on a motorized table equipped with continuous monitoring of heart rate and blood pressure, and often additional sensors. After a baseline period in the supine position, the table is tilted to an upright angle, typically about 60–70 degrees, and held for a period ranging from 20 to 60 minutes. If the test does not provoke a response, pharmacological provocation may be used to increase sensitivity, commonly with agents such as isoproterenol or nitroglycerin. In pediatric and adult protocols, exact angles, durations, and pharmacologic choices may differ.

Interpretation and indications: A positive kallistuskoe reproduces presyncope or syncope with accompanying hemodynamic changes, such as a drop in blood pressure, sometimes with bradycardia or other heart-rate abnormalities. The test is especially helpful in diagnosing vasovagal (neurally mediated) syncope and in assessing autonomic dysfunction related to orthostatic intolerance or postural tachycardia syndrome. It is typically considered after initial clinical workup and basic testing has not established a cause of syncope.

Safety and limitations: While generally safe when performed in a controlled setting, the test carries a risk of transient syncope and related injuries, and is contraindicated in certain acute conditions. False positives and negatives can occur, so results are interpreted in the context of clinical history and other investigations.