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 investigation of orthostatic symptoms. Although this test is frequently the gold standard for the evaluation of neurocardiogenic syncope, dysautonomia and postural orthostatic tachycardia syndrome, there is a debate over its diagnostic value and method. The authors review the physiologic basis of the HUT test, the method, patterns of response, indications and contraindications, and diagnostic validity. Despite its limitations, the HUT test is useful in patients with a variety of clinical manifestations induced by orthostatism. It is most useful in documenting objective measures of orthostatic hypertension that cannot be obtained in a clinical setting.