To prepare for the tilt table test, patients may be asked to stop eating and drinking for at least six hours prior to the test. By completing the test on an empty stomach, patients are at less risk of side effects, such as nausea and vomiting. Most medications can be taken with only a sip of water, but the physician may ask a patient to suspend beta blockers, vasodilators and/or diuretics shortly before testing. Patients should always consult their physicians before changing their medication schedule.

At the test site, the procedure will be explained, and the patient will have the opportunity to ask questions. There may be some paperwork to complete, including a medical history and/or a test consent form. The patient may be required to change into a hospital gown.

To begin, the patient is strapped to a special table on his or her back. Electrodes are typically attached to the chest and back to provide information about the heart’s activity in an electrocardiogram (EKG) read-out. The patient’s symptoms, blood pressure, pulse and possibly blood oxygen saturation will be recorded during the test. In some cases, an intravenous (I.V.) line may be started in the patient's arm to provide medication, if necessary, that simulates the effect of adrenaline.

After the patient is secured to the table, blood pressure and heart monitoring may last for 10 minutes, in a normal reclined position, to establish a baseline. After the baseline is established, the table is moved into an almost upright position, with the patient's head above his or her feet, in a series of progressively steeper angles up to as much as 70 degrees. This portion of the test may last up to 45 minutes. There may be observable signs of fainting (syncope) but the spells will only last a short time before recovery.

If no signs of fainting emerge during the test, the table is reclined again and the patient may be given medication through the I.V. The medication is designed to provoke fainting in susceptible patients, which can help the physician determine the cause of the fainting.The test is performed again and the patient’s responses are recorded.

Patients are monitored by healthcare professionals throughout the test. Patients who do not feel well at any point during the test should tell a medical professional immediately. Depending on the protocol, the test usually takes 30 to 45 minutes but may take more than an hour in some cases.