The role of the head-up tilt test in clinical and therapeutic management in paediatric age

Ugo Giordano, A. Turchetta, G. Crosio, A. Nigro, B. Di Giacinto, A. Calzolari

Research output: Contribution to journalArticlepeer-review


Aim. Syncope is a sudden and transient loss of consciousness that causes the incapacity to maintain the postural tone due to a reduction or interruption of the blood flow to the brain; its incidence seems to peak during adolescence. The aim of our study was to assess the usefulness of the tilt test in patients with recurrent syncopal episodes and to underline its role in the clinical and therapeutic management in pediatric age. Methods. Seventy-nine children and adolescents (40 M; 39 F) with a mean age of 12.3 ± 3.5 years were examined. All patients underwent a clinical examination, a 12-lead electrocardiogram with the measurement of systolic and diastolic blood pressure at rest, and the head-up tilt test. The test was interrupted in case of hypotension (vasodepressor response) or cardiac arrest (cardioinibitory response). The combination of these two signs was considered as a «omixed» response. Results. Forty-nine tests were positive, 23 for vasodepressor response, 12 for cardioinhibitory response and 9 for both; in 5 patients the test was interrupted for neurovegetative symptoms. Conclusions. Our results demonstrate that the tilt test is useful for the diagnosis of syncope, especially when the clinical history of the patient is not typical of neurocardiogenic aetiology, to understand the pathophysiology that causes the symptoms and to evaluate the efficacy of therapy even if it may be difficult to assess the reproducibility of the test.

Original languageEnglish
Pages (from-to)484-487
Number of pages4
JournalItalian Journal of Pediatrics
Issue number6
Publication statusPublished - Dec 2002


  • Child
  • Head-up tilt test
  • Syncope

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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