When do pregnancy symptoms = trip to the ER

24F 5’7” ~130lbs non smoker or alcohol, 19 weeks pregnant with a previous history of orthostatic hypotension (not POTS), SFN, gastroparesis, pseudocerebri tumor (from a medication).

This entire pregnancy I have been fainting, like multiple times a week. Now it’s progressed to fainting several times a day. I’ve heard the whole “don’t stand up too quickly” thing and followed the protocol, but times I’ve passed out also include: showering, blowing my nose too hard, and having sex so it’s not that I don’t know how to stand up slowly.

I was referred to MFM by my OB who assured me at 16 weeks that “nobody ever faints moving into the second trimester” and something along the lines of the uterus changing positions will make me less dizzy. She also said as long as the baby was healthy I would be fine. I do know they’re having me do an anesthesia consult because I always have very low oxygen and BP numbers after surgeries but that won’t be until 30+ weeks pregnant.

Am I supposed to just keep going with fainting this often? Nobody seems to be that concerned about it besides making referrals to cardiology who can’t see me for another month. I don’t want to keep passing out but idk if the ER will be as ambivalent about this as MFM seems to be.

Update: OB sent me to ER. Found IVCD on EKG and will have cardiology follow up in a month. VERY high neutrophils, very low albumin and also albumin/globulin ratio. They basically said my body has inflammation that could be related to pregnancy. Had a bag of IV lactated ringers and discharged with the instructions “don’t stand up too quickly” just like they all say. Not sure why OB thought it would be more productive, but I do have a new data point regarding EKGs and some blood work.