Tilt table test helps diagnose fainting
Dear Dr. Roach: I suffer from what seems to be vasovagal syncope. My family doctor is suggesting that I have a tilt table test. Could you elaborate on this kind of test? I have had stress tests and echocardiograms. I also have seen an electrophysiologist (in 2015) who was not inclined to recommend this test.
R.M.A.
Answer: Vasovagal syncope is the precise name for a common faint. It is a neurological reflex. That’s what “vasovagal” means — the vagus nerve controls heart rate, to a large extent, as well as the blood ves- sels themselves. The vagus nerve can slow down the heart and dilate blood vessels inappropriately due to neurological signals, causing blood pressure to go down, in response to many conditions, such as emotional stress, pain, fear, prolonged standing and heat exposure.
An experienced clinician usually can make the diagnosis of vasovagal syncope by a careful history and physical exam. Occasionally, there are times when the diagnosis is not clear, and the tilt table test is designed to evaluate that possibility.
A tilt table test is usually performed in an electro- physiology laboratory, so the fact that the electrophysiologist doesn’t recommend it carries weight with me. Your family doctor and cardiologist should make a combined decision about whether you need it.
Dear Dr. Roach: There is a recall of eggs near me due to salmonella. I always notify a friend online about recalls. But she says that as long as she washes her hands and her eggs, she doesn’t care about the recall. Why would they recall eggs if this was all a person had to do? What can I say to change her mind?
D.D. Answer: Tell her that you can’t tell whether an egg has salmonella by looking at it, and that washing eggs can bring salmonella from the outside of the egg to the inside.
Also, salmonella requires either high heat or low heat for a long time to be killed, which would make the egg unpalatable or inedible. Recalled eggs should NOT be eaten. It’s not worth the risk. Readers may email questions to: ToYourGoodHealth@med .cornell.edu or mail questions to 628 Virginia Dr., Orlando, FL 32803.