During tilt-table testing, which symptom would be least anticipated as the patient becomes upright?

• A. Syncope
• B. Dizziness
• C. Nausea
• D. Bradycardia

Answer: (D)

Tilt-table testing gauges how the autonomic system handles a sudden upright posture. When upright, blood pools in the legs, venous return drops, and cerebral perfusion can fall. The body's usual reflex is to raise heart rate and tighten vessels to maintain blood pressure and brain perfusion, so dizziness or lightheadedness are common, and syncope can occur if compensation fails. Nausea can accompany reduced cerebral perfusion as well. A decrease in heart rate, or bradycardia, is not the typical early response; it would lessen the heart’s ability to compensate for the drop in blood pressure and therefore is not expected during the initial upright tilt. Thus bradycardia would be the least anticipated symptom as the patient becomes upright.