During pregnancy, the body's blood volume increases. The heart needs to pump faster to circulate the extra blood, and this can lead to a faster resting heart rate. Sometimes, the extra exertion on the heart can lead to palpitations.

A heart palpitation may feel as though the heart is:

- skipping beats

- racing

- flopping in the chest

Heart palpitations are usually harmless. However, in some cases, they can indicate a problem in the heart or elsewhere in the body.

What are the symptoms?

Heart palpitations can cause a wide variety of symptoms. Pregnant women may experience one or any combination of the following:

- dizziness or lightheadedness

- a feeling of uneasiness

- a feeling that the heart is pounding

- a rapid heartbeat

- sweating

- a fluttering or flopping feeling in the chest

- a sensation of the heart skipping beats

Causes

A variety of factors can cause heart palpitations during pregnancy. Most are not serious.

In some cases, however, the underlying cause of the palpitations requires medical treatment.

Some harmless causes of heart palpitations during pregnancy include:

- the heart reacting to the increase in blood volume

- stress and anxiety

- reactions to certain food or drinks, especially those that contain caffeine

- reactions to cold or allergy medications

More serious causes include:

- thyroid problems

- underlying heart damage from another life event or pregnancy

- pulmonary hypertension

- coronary artery disease

- abnormal heart rhythms, which are called arrhythmias

- preeclampsia and other hypertensive disorders of pregnancy

Pregnant women and healthcare providers may find it difficult to distinguish the cause of palpitations.

Many symptoms of heart problems occur during a normal pregnancy, making it hard to know whether an underlying condition is causing the symptoms.

Diagnosis

Drinking caffeinated drinks while pregnant can cause heart palpitations.

Only a doctor can correctly diagnose the cause of heart palpitations. The doctor will usually begin by asking about symptoms and medical history.

If a woman has any of the following, it is important to tell the doctor:

• a history of heart palpitations

• a history of heart disease

• a history of other problems that affect the heart

• a family history of heart disease

The doctor will usually then perform an exam and listen for abnormalities of the heartbeat. They will often perform additional tests to pinpoint the underlying cause of the palpitations.

The doctor may use any of the following to make a diagnosis:

• blood tests to look for imbalances and check the functioning of the thyroid

• an electrocardiogram to measure the heart's electrical activity

• a Holter monitor test, which involves wearing a device that measures the heart's rhythms for an extended period

When to see a doctor

A woman attends several scheduled visits during pregnancy. The frequency of these visits will increase as the due date approaches, or if the doctor suspects that there are complications.

If heart palpitations occur more frequently between visits, become more intense, or last for increasingly long periods, a woman should contact the doctor.

Seek emergency medical attention if any of the following symptoms occur with heart palpitations:

• a bloody cough

• an irregular pulse

• labored breathing when not exerting effort

• trouble breathing

• pain in the chest

• a rapid heart rate

How to stop heart palpitations

Seek medical attention if heart palpitations occur regularly during pregnancy.

Heart palpitations do not necessarily require treatment.

When symptoms are mild and do not result from an underlying condition, a doctor will usually not recommend treatment, and a woman can expect the palpitations to end with the pregnancy.

If symptoms are severe, a doctor may prescribe medication to regulate the heartbeat. The doctor will discuss the risks to the woman and fetus before prescribing medication.

The risks are higher during the first trimester, and a doctor is unlikely to prescribe medication then.

If a woman has an arrhythmia, a doctor can use a timed electrical current to return the heart to its normal rhythm. This procedure, called cardioversion, is considered safe during pregnancy.

Takeaway

Many pregnant women experience heart palpitations. They may be disconcerting, but most heart palpitations are harmless.

However, they can result from underlying problems that require medical treatment. Any pregnant woman who experiences heart palpitations should report her symptoms to her doctor for further evaluation because of this.

Heart palpitations during pregnancy often do not require treatment. For those who need treatment, many safe options are available.