I’ve known about my Chiari for a year now but the issues started about 15 years ago. Over the past two years I’ve been having increasingly severe presyncope episodes which are getting worse. I’m sure I’m only one episode away from actually passing out.

This happens after I’ve been sitting for an extended period of time. I’ll stand up and my blood pressure drops so massively that I almost lose consciousness. This weekend it happened after I had been driving for about four hours. This time, it happened before I stood up. All I did was sit up and turn my head when I was pulling off at an exit ramp. I barely parked the car at the gas station and had to lay back in my seat to recover. This one scared me.

I know this is orthostatic hypotension. What I don’t know and what my doctor’s can’t tell me is what’s causing it. Full cardiac workup showed a healthy heart and cardiologist says it’s neurological. Neurologist says it’s cardiac.

I do know the type of chair I’m sitting in and how long I’ve been sitting will affect how long it takes to trigger an episode.

Anyone have similar issues? Anything helped?

Followup in case someone else is searching in the future:

I actually had a spontaneous CSF leak. I was taking amitriptyline and it was exacerbating the orthostatic hypotension. I switched to a different anti depressant and it cleared up quite a bit and has almost completely cleared up after repair of the CSF leak.