I've just been diagnosed with postural hypotension and reflex syncope. Prior to fainting I feel my heart absolutely racing, if I then sit, drink lots water or sometimes just move around it begins to receed but I don't always have warning before blacking out or it comes on too quick. Ive had about 15 blackouts now in past 4 months, but most days feel I'm warding them off, it's generally when I've had to stand for a while, eg queuing, but sometimes comes on immediately on standing if I've sat still for a while, ie college/church etc. Info I've read talks more of a drop in heart rate for reflex syncope when mine definitely goes faster, but POTS although many similar symptoms, talks of a fast heart rate within 10 mins of standing. Mine rarely happens that quick, im generally already up and about and it starts when I then stand still. Tilt table, showed a drop in BP on standing then steadying, only slight rise in HR but after GTN spray whilst BP remained the same by HR increased to 150. I've been told I have to self manage but feeling rather frustrated as the blackouts happen more or less weekly and I'm concerned at whether there are any long term risks when my heart seems to race so much. Any advice?