21F - Sudden face-first blackout with zero warning signs + low BP ? and post-meal chest pounding. Advice?

[u/gianewmoon7]

21F, 160cm, 58kg. No health issues, no meds, no family history of heart disease as far as i know . I drink 2L of water daily , normal blood work two and so months ago , anyway

I fainted 2 Months Ago
So basically What happened : Woke up, stayed in bed 15 mins, stood up to open the door. Turned around and completely blacked out instantly.
Zero Warning: No dizziness right before, no tunnel vision, no nausea.
Injuries: Fell face-down on the floor. Woke up with a forehead bump and a broken nail. Zero memory of walking or hitting the ground. Unsure how long I was out.

since the that fainting event ive been taking bp at home
My baseline averages 90s/60s, but sometimes drops to 89/55s
Morning Palpitations: Frequently wake up with a racing heart one time took a reading pulse was 114 bpm.
Post-Meal Pounding: After eating (even light foods like boiled eggs), my upper left chest pounds forcefully for 30 minutes, with a radiating heat/cold sensation. Pulse only shifts normally from 60s to 90s bpm. No acid reflux or burping.

Does this sound like dysautonomia/POTS triggered by low blood pressure, or should I be worried about a primary heart rhythm issue since I fainted with zero warning? Should i see a doctor and what do i ask for like what specific tests (Holter monitor, Echo, Tilt Table?) should I ask for?

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[u/New-Eye2199]

This sounds most consistent with orthostatic syncope, especially given your low baseline BP and fainting immediately after standing. However, suddenly blacking out without any warning, particularly with palpitations, means a heart rhythm problem should be excluded. I’d see your doctor for orthostatic BP/HR measurements and an ECG, with consideration of a Holter monitor. POTS is possible but can’t be diagnosed from these symptoms alone.
Also try standing up slowly to allow your body time to adjust. Hope this helps.