Heart palpitations are sensations of a racing, pounding, or skipped heartbeat felt in the chest, neck, or throat. This experience is common and usually benign during pregnancy. The cardiovascular system undergoes significant changes to support the developing fetus, leading to noticeable heart rhythm changes. While the feeling of a fluttering heart can be unsettling, most pregnancy-related palpitations are a normal physical response to the body’s increased workload. Understanding the difference between these harmless episodes and signs requiring immediate medical evaluation is important.
The Physiological Reasons Palpitations Occur During Pregnancy
The body’s demand to support the developing fetus causes profound cardiovascular adjustments. A significant change is the increase in blood volume, which can rise by up to 50% above pre-pregnancy levels. This substantial increase necessitates the heart working harder to circulate blood throughout the mother’s body and the placenta.
The heart’s output, the amount of blood it pumps per minute, increases by 30% to 50% to handle the extra volume. To achieve this, the resting heart rate typically rises by 10 to 20 beats per minute, starting early in the first trimester. This naturally faster heart rate can be perceived as a palpitation, especially when the rate exceeds 90 beats per minute.
Hormonal shifts, such as the surge in progesterone, directly affect the heart’s electrical system and influence rhythm. In later pregnancy, the growing uterus pushes the diaphragm upward, causing the heart to sit higher in the chest. This altered mechanical position can contribute to the sensation of irregular heartbeats. Palpitations may also be triggered by common issues like anemia, which forces the heart to pump harder for oxygen delivery, or from thyroid changes.
Distinguishing Between Normal and Concerning Palpitations
The majority of heart palpitations experienced during pregnancy are benign, isolated events resulting from the body’s normal adaptations. They typically manifest as brief flutters, skipped beats, or a sudden quickened pace that resolves within moments. These normal sensations are often triggered by movement, stress, sudden changes in position, or consumption of stimulants like caffeine.
Palpitations can occasionally signal an underlying cardiac or systemic health issue, making it important to monitor associated symptoms. A key factor in distinguishing concerning palpitations is whether they are accompanied by other signs of distress or systemic issues. Palpitations that are persistent, intense, or last for longer periods warrant medical attention.
Symptoms that indicate a palpitation may be more than a harmless flutter are called “red flags” and require immediate evaluation. These concerning indicators suggest a potential compromise to the heart’s function.
Red Flags Requiring Immediate Evaluation
Palpitations accompanied by the following symptoms require immediate medical attention:
- Chest pain or discomfort, which may suggest a lack of blood flow to the heart muscle.
- Severe shortness of breath, particularly when resting.
- Dizziness, lightheadedness, or fainting (syncope).
- Significant swelling (edema) in the legs, ankles, or feet.
Management and When to Seek Immediate Medical Attention
For the frequent, non-disabling palpitations common in pregnancy, simple lifestyle adjustments can often help reduce their occurrence. Staying adequately hydrated is effective, as dehydration places additional stress on the cardiovascular system and can exacerbate palpitations. Reducing the intake of stimulants, such as caffeine found in coffee, tea, and some sodas, can help stabilize the heart rate.
Management also involves adopting techniques to minimize anxiety and stress, which are known triggers for heart flutters. Practicing deep breathing exercises or engaging in relaxation methods can help calm the mind and body. Avoiding sudden changes in body position, such as rapidly standing up, can also prevent temporary spikes in heart rate and subsequent palpitations.
If palpitations become more frequent, increase in intensity, or last for increasingly longer durations, contact a healthcare provider for a non-emergent appointment. The provider may perform an evaluation, including blood work or an electrocardiogram, to rule out conditions like anemia or thyroid issues.
If palpitations occur alongside any of the severe warning signs previously discussed, immediate medical attention is necessary. Calling emergency services is the appropriate response to ensure prompt diagnosis and treatment. These severe symptoms suggest a potential compromise to the heart’s function that requires urgent clinical intervention for the safety of both the mother and the fetus.