Heart palpitations are a subjective feeling of a skipped, racing, or fluttering heartbeat that a person can consciously perceive in the chest, throat, or neck. While often alarming, they are a very common symptom reported during pregnancy. The majority of these episodes are benign and result directly from the dramatic physiological changes the body undergoes to support the developing fetus. Understanding the causes and recognizing signs that warrant medical attention is important, even though most pregnancy-related heart flutters are harmless.
Why Pregnancy Alters Heart Function
Pregnancy places a significant workload on the cardiovascular system, which must adapt substantially to meet the demands of the growing fetus. The most notable change is a dramatic increase in blood volume, rising up to 50% above pre-pregnancy levels by the third trimester. This extra volume forces the heart to pump harder and faster to circulate blood effectively, including through the newly formed placental circulation. The heart’s cardiac output, the amount of blood pumped per minute, rises by 30% to 50% to accommodate this change.
The body’s hormonal environment also plays a large role in altering heart function. Surges in hormones like estrogen and progesterone can directly affect the heart’s electrical system, making it more sensitive and prone to extra beats. The heart rate typically increases by 10 to 25 beats per minute above the woman’s baseline resting rate. This increased baseline rate means the heart is already working at an elevated capacity, making minor irregularities more noticeable.
As pregnancy advances, mechanical factors begin to influence the heart’s position and function. The upward pressure from the enlarging uterus pushes the diaphragm higher into the chest cavity. This shift physically changes the orientation of the heart, which may contribute to the sensation of palpitations. The combination of increased blood volume, hormonal shifts, and mechanical pressure creates an environment where a person is more likely to perceive their heart beating.
Recognizing Common Pregnancy Palpitations
Common pregnancy palpitations are typically characterized by brief, sporadic, and short-lived episodes. A person might feel a momentary sensation of the heart “skipping a beat” or a rapid, brief flutter within the chest. Other descriptions include a forceful pound or a sudden rush of racing heartbeats that resolve quickly.
These normal palpitations often represent premature atrial contractions or premature ventricular contractions (extra heartbeats arising from the upper or lower chambers of the heart). While disconcerting, these extra beats are common in the general population, and heightened awareness during pregnancy makes them more perceptible. The episodes are usually isolated, lasting only a few seconds, and do not typically interfere with daily activities or require intervention.
When Palpitations Require Medical Review
While most palpitations are benign, certain associated symptoms indicate an underlying issue and require immediate medical consultation. A sustained, persistent racing heart (tachycardia) is a red flag, especially if the rapid rate does not quickly subside. Palpitations accompanied by chest pain or discomfort should prompt urgent evaluation to rule out serious cardiac concerns.
Shortness of breath (dyspnea) warrants medical review, particularly if it occurs at rest or with minimal activity. This symptom, distinct from the mild breathlessness common in later pregnancy, can suggest the heart is struggling to pump efficiently. Dizziness, lightheadedness, or fainting (syncope) associated with palpitations are serious warning signs. These symptoms may point to problems like severe anemia, which forces the heart to work excessively hard, or an underlying thyroid condition like hyperthyroidism, which can significantly accelerate heart rate. Unexplained and severe fatigue that goes beyond typical pregnancy tiredness also necessitates a comprehensive medical assessment.
Lifestyle Adjustments to Minimize Episodes
For mild, non-threatening palpitations, several self-care strategies can help reduce the frequency of episodes. Maintaining adequate hydration is important, as dehydration can lower blood pressure and cause electrolyte imbalances that trigger heart rhythm changes. Consuming sufficient water supports the increased blood volume and overall cardiovascular function.
Limiting or eliminating stimulants like caffeine is an effective strategy, as excessive intake can overstimulate the heart and worsen palpitations. Nicotine and alcohol consumption should be avoided completely during pregnancy, as they can harm the fetus and increase the risk of irregular heartbeats.
Managing anxiety and stress through techniques like deep breathing or meditation can help, since stress hormones like adrenaline can directly provoke a racing heart. People should avoid sudden changes in posture, such as standing up too quickly, which can cause a temporary drop in blood pressure and trigger a palpitation-like sensation. Ensuring consistent and sufficient sleep helps regulate the body’s systems and may contribute to fewer episodes.