Heart Palpitations in Pregnancy

What are heart palpitations in pregnancy?

Heart palpitations cause your heart to feel like it’s pounding, racing or beating too quickly. Your heart rate might speed up, slow down or skip a beat. Some people feel like they have an extra heartbeat.

Heart palpitations in pregnancy are very common. During pregnancy, the amount of blood in your body increases significantly. Your heart works harder to pump the extra blood throughout your body and to the fetus. This extra work can result in heart palpitations.

Although they can be alarming, most pregnancy heart palpitations aren’t dangerous. They usually go away after delivery. Less commonly, heart palpitations can be a sign of a serious health problem, such as arrhythmia (abnormal heart rhythm). If you have palpitations along with chest pain, trouble breathing, dizziness or confusion, get immediate medical help.

How common are heart palpitations during pregnancy?

It’s very common to have heart palpitations during pregnancy. They are especially common as people move into their third trimester and the fetus continues to grow. As it gets bigger, it needs additional blood to stay healthy.

If you had an arrhythmia or other type of heart disease before you got pregnant, you’re more likely to have symptoms during pregnancy. They may happen more often or worsen while you’re pregnant.

What are the symptoms of heart palpitations during pregnancy?

Symptoms of heart palpitations include:

• Fluttering: Some people describe sensing a flapping or fluttery feeling in their chest. Your heart may feel like it’s doing flips.
• Irregular heart rate: It might feel like your heart skips a beat, it’s beating out of rhythm, or speeding up and slowing down. It can also seem like your heart stops for a second or two.
• Pounding: You might feel like your heart is beating forcefully or very hard. Some people who feel their heart pounding say they can hear it beating in their ears.

What causes pregnancy heart palpitations?

During pregnancy, many changes happen that affect your entire body, including your heart and blood vessels. Over the course of pregnancy, your blood volume increases by almost 50%. This means your heart has to work harder to pump blood through your body. It sends much of this blood to your growing fetus. Your heart rate speeds up to get the job done.

Many factors can increase your risk of heart palpitations when you’re pregnant. They include:

• Anemia (low red blood cell count). This condition commonly affects pregnant people because of changes in the blood during pregnancy. Fluid in the blood increases more than the number of red blood cells, which can lead to anemia.
• Anxiety and depression. Heart palpitations can happen if you’re under a lot of stress or feel anxious.
• Caffeine, especially in coffee and chocolate. Foods that are high in carbohydrates, sodium (salt), sugar or fat can cause a racing heart.
• Dehydration and electrolyte imbalances. Electrolytes are minerals that control your heart’s rhythm.
• Extra weight and obesity. People who carry extra weight before and during pregnancy have an increased risk of irregular heart rate and other heart disease.
• Hormonal changes (such as shifts in the hormone estrogen) that happen during pregnancy.
• Hypoglycemia (low blood sugar), which happens more often in the first trimester.
• Hypotension (low blood pressure), a common condition during pregnancy.

Less commonly, heart palpitations result from a health condition or disorder, including:

• Heart rhythm problems (arrhythmias) such as atrial fibrillation (Afib) can cause or worsen heart palpitations during pregnancy. In rare occurrences, a heart attack, heart failure or cardiomyopathy can lead to heart problems while pregnant.
• Myocarditis, inflammation of the heart muscle that results from a viral infection.
• Thyroid problems, such as hyperthyroidism.
• Structural problems in the heart, including valve disease.

How do healthcare providers diagnose heart palpitations during pregnancy?

Your provider will ask about your symptoms and listen to your heart. To check for an underlying condition, they may recommend a blood test (complete blood count or CBC). This test looks for anemia, infections and vitamin deficiencies. It can also detect problems with your thyroid.

To monitor your heart rate and check for heart disease, they may do an electrocardiogram (EKG or ECG). This test measures your heart rate using sensors that attach to your skin. It usually takes about 15 minutes. Your provider may ask you to lie down. Or they might ask you to do light exercise (such as walking on a treadmill) during the test. It is safe to perform this test during pregnancy.

Many times, an EKG doesn’t detect heart palpitations. You might not have an irregular heartbeat during the test. If this happens, your provider may recommend an ambulatory electrocardiogram such as a Holter monitor. You wear this device for up to two weeks as you go about your daily activities. It records your heart rate (and any irregular heartbeats) and stores the information for your provider to review.

How do providers treat heart palpitations during pregnancy?

Most of the time, heart palpitations during pregnancy don’t require treatment. If they only happen occasionally and don’t result from a heart condition or other health problem, your provider may recommend diet and lifestyle changes. These include:

• Drinking plenty of water: It’s essential to stay hydrated while you’re pregnant. Your body needs extra fluids to help you and your fetus stay healthy. Avoid alcohol and nicotine during pregnancy. Smoking and drinking alcohol can harm your fetus and increase the risk of heart palpitations.
• Limiting caffeine, sugar and fat: Coffee and chocolate can make heart palpitations worse. Stick to one cup of coffee a day, and eat chocolate and other sugary or caffeinated foods in moderation. Limit foods that are high in fat or sodium (salt).
• Trying relaxation techniques: If you’re having heart palpitations, take long, deep breaths in through your nose and out through your mouth. You can also use pursed lip breathing techniques and meditation.

If you have a heart condition or other health condition that’s causing palpitations, your provider will develop a treatment plan that’s safe for you and your fetus. Treatments vary depending on the cause.

Sometimes, providers prescribe a type of medicine called beta blockers to treat palpitations. Your provider will discuss this medication and any other treatments with you. They will help you weigh the benefits of treatments and risks of side effects that might affect your fetus.

Can I prevent heart palpitations during pregnancy?

You may not be able to prevent heart palpitations during pregnancy, but you can lower your risk. You should:

• Eat a balanced diet and avoid foods that are high in fat, carbs, salt or sugar.
• Get treatment for anxiety or depression.
• Limit caffeine and don’t drink alcohol. If you smoke, talk to your provider about a plan to quit smoking.
• Maintain a healthy weight.
• Meditate or practice yoga. And, try diaphragmatic breathing and other relaxation techniques to lower your stress level.

See your provider regularly. You should schedule frequent visits so your provider can monitor your health and your fetus’s wellbeing. Tell your provider if palpitations get worse.

What is the outlook for people with heart palpitations during pregnancy?

Most people with heart palpitations during pregnancy don’t require treatment. Palpitations usually go away after delivery. Diet and lifestyle changes, such as eating right and reducing stress, can help most pregnant people manage heart palpitations.

If you have a health condition that’s causing palpitations, talk to your provider. You should work closely with them to develop a treatment plan that is effective and safe for you and your fetus.

When should I see my healthcare provider about heart palpitations during pregnancy?

Tell your provider about your symptoms. Although it’s rare for heart palpitations during pregnancy to be dangerous, you should talk to your provider so they can monitor your health.

Get help right away if you have heart palpitations and:

• Chest pain or discomfort.
• Difficulty breathing, shortness of breath or other breathing problems.
• Dizziness or confusion.
• Loss of consciousness or fainting (syncope).
• Severe swelling (edema) in your limbs, especially your legs, ankles and feet.
• Unusual or sudden fatigue.

A note from Cleveland Clinic

Most of the time, heart palpitations during pregnancy aren’t serious. They are a natural result of increased blood flow in your body. But you should tell your provider about heart palpitations, especially if they happen often. In rare cases, a serious health condition may be causing your symptoms. To lower your risk of palpitations, drink plenty of water, avoid caffeine and never drink alcohol while pregnant. Practice deep breathing exercises to calm your mind and relax your body. If you have heart palpitations along with chest pain, trouble breathing or dizziness, get help right away.