Heart Racing While Pregnant?
What to Know, and When to Reach Out
Contents
Heart palpitations are common in pregnancy1 and are usually harmless in people without heart disease. Plasma volume, the liquid part of the blood, increases by about 48 percent2 by weeks 35 to 38 in healthy pregnancies and your resting heart rate climbs1, so your heart may flutter, pound, skip, or race. Reach out for care if palpitations come with fainting, significant chest pressure or severe chest pain, or difficulty breathing at rest, or if they don’t settle after a few minutes.
Your heart is working harder than usual right now, so it’s not surprising if you notice it. This guide walks through what's happening, what's typically normal, and which signs mean it's time to get checked.
What pregnancy palpitations feel like
People describe them in different ways:
A "flip-flop" feeling
A fluttering in the chest or throat
A pounding or thumping heartbeat
A racing pulse, even while resting
A skipped beat or an extra beat
How a palpitation feels doesn’t always match what the heart is doing. A strong, fast-feeling heartbeat can be a normal rhythm, and some rhythm changes aren’t felt at all. For this reason, a heart monitor can be more informative than symptoms alone.
When to get care for a racing heart in pregnancy
Most palpitations are not a sign of heart disease. A few symptoms need prompt attention, so it helps to know them ahead of time.
Get emergency care right away if you have:
Fainting or near-fainting
Significant pressure or severe pain in the chest lasting more than 10 minutes
Difficulty breathing at rest
Call your care team the same day if you have palpitations along with:
A racing heart that doesn't settle after a few minutes of rest
Shortness of breath when lying flat, or waking up breathless
Sudden swelling in your face, hands, or legs, especially with a severe headache or vision changes
Lightheadedness or dizziness that keeps coming back
Palpitations that are new in the last month of pregnancy or in the weeks and months after delivery
Trust your instincts. If something feels wrong, reach out to your care team.
Common causes of heart palpitations during pregnancy
Pregnancy increases the workload of the cardiovascular system, and the changes begin early. Common reasons your heart may beat faster or feel different include:
More fluid to circulate. Plasma volume, the liquid part of blood, rises steadily during pregnancy2, so your heart circulates more fluid as pregnancy progresses.
A higher heart rate. It typically rises as pregnancy progresses3, and resting heart rate rises by about 10 beats per minute on average by the third trimester4. Some reviews cite larger increases, up to 20 beats per minute5, and the change varies from person to person.
Hormone shifts. Pregnancy hormones can affect blood vessels6 and may influence the heart’s electrical activity7.
Low iron or anemia. Iron requirements rise substantially during pregnancy8, which can lead to a deficiency. When iron is low, the heart may work harder to deliver oxygen.
Dehydration. Morning sickness and heat can lower fluid levels.
Caffeine. The American College of Obstetricians and Gynecologists (ACOG) states that moderate intake, less than 200 mg per day, does not appear to be a major contributor to miscarriage or preterm birth9. Research is mixed, though, and some studies have linked lower amounts to other outcomes10. Caffeine can also make palpitations more noticeable.
Stress, anxiety, and poor sleep. Each can make palpitations more noticeable.
Thyroid changes. An overactive thyroid can cause a fast heart rate11, and this can be checked with a simple blood test12.
For many people, one or more of these explains the symptoms.
How palpitations can change by trimester and after delivery
They can, and they can start at any point.
First trimester. Hormone changes are a common driver, and plasma volume begins to rise. Nausea, vomiting, and dehydration can add to it.
Second trimester. Plasma volume rises fastest in this trimester2, and heart rate continues to rise. Some people notice palpitations ease, while others notice them more.
Third trimester. Plasma volume reaches its highest level, and the growing uterus can affect breathing and how you feel lying down.
After delivery. The weeks and months after birth are a separate window to watch. Heart problems can appear postpartum, including a rare form of heart failure called peripartum cardiomyopathy, so new symptoms after delivery deserve a call to your care team.
When palpitations can signal a heart condition
Usually they aren't. Occasionally, palpitations point to a condition that needs evaluation:
An arrhythmia, such as supraventricular tachycardia (SVT) or atrial fibrillation. Many arrhythmias can be treated safely during pregnancy.
Peripartum cardiomyopathy, a rare weakening of the heart muscle that can appear in the last month of pregnancy or in the months after delivery. Symptoms include breathlessness, swelling, fatigue, and palpitations.
A heart valve or structural condition that was not diagnosed before. Pregnancy can unmask conditions that did not cause symptoms earlier.
Preeclampsia, a blood pressure condition that can strain the heart. It usually develops after 20 weeks and can occur after delivery.
Some symptoms, such as fatigue and mild breathlessness, resemble normal pregnancy symptoms, so it can be hard to tell the difference on your own. A cardiology evaluation can help sort this out.
How palpitations are evaluated during pregnancy
The evaluation is typically simple and safe for you and your baby:
A conversation about your symptoms: when they happen, how long they last, what you were doing, and your personal and family history.
An electrocardiogram (ECG), which records your heart’s electrical activity.
A wearable heart monitor, such as a Holter or event monitor, worn for days to weeks to capture rhythm changes in daily life.
An echocardiogram, an ultrasound of the heart that looks at structure and pumping function.
Blood tests, often including a blood count and thyroid levels.
These tests do not use radiation.
What can help at home
If your clinician has told you your palpitations are benign, these steps often help:
Drink water throughout the day
Cut back on caffeine
Eat smaller, more frequent meals
Prioritize sleep. Later in pregnancy, lying on your side instead of flat on your back helps improve bloodflow13. Either side is considered safe14, so choose the one that’s more comfortable.
Try slow breathing or gentle movement when you feel anxious
Keep a simple log of episodes: the time, how long it lasted, what you were doing, and any other symptoms
Bring the log to your visit, since patterns help a cardiologist decide what to check. Do not start or stop any medication without talking to your care team first.
Virtual cardiology care during pregnancy
A virtual (online) cardiology visit can be a convenient first step, particularly if you live far from a cardiology office or want to avoid extra trips during pregnancy.
A telehealth visit can:
Review your symptoms, history, and risk factors
Order and interpret a wearable heart monitor shipped to your home
Arrange an ECG or echocardiogram near you when one is needed
Review results and build a plan
Coordinate with your OB-GYN or midwife so your care team stays aligned
Provide follow-up, including postpartum check-ins
Some situations need in-person care:
Emergency symptoms, such as significant pressure or severe pain in the chest, fainting, or difficulty breathing at rest
Tests and treatments that can’t be done remotely. A virtual-first cardiology group such as Empallo Health can coordinate this care with providers in your local community.
Frequently asked questions (FAQs)
What’s a normal heart rate in pregnancy, and when is it too high?
Resting heart rate usually rises during pregnancy, by about 10 beats per minute on average by the third trimester. Many people have resting rates in the 70s to 80s, and some see readings in the 90s. A resting rate that stays above 100 beats per minute isn’t typical, so have it checked even if you feel fine.
Brief increases are common and usually aren’t a concern on their own. Activity, stress, caffeine, heat, and dehydration can all raise your heart rate temporarily. To check your resting rate, sit quietly for five minutes, then count your pulse for 30 seconds and double the number. You can also use a wearable device while you’re resting.
Can anxiety cause heart palpitations during pregnancy?
Yes. Stress and anxiety can make your heart feel faster and more noticeable. Because pregnancy changes can feel similar, it is still worth having new or persistent palpitations checked so you know the cause.
Are heart palpitations at night normal in pregnancy?
They are common. It is quieter at night, you are more aware of your body, and lying down can change how your heart feels. If night-time palpitations come with breathlessness or wake you from sleep, mention it to your clinician.
Are palpitations harmful to my baby?
Benign palpitations don’t usually harm the baby. If an arrhythmia or another heart condition is found, there are well-established ways to manage it during pregnancy, and your care team will choose treatments that take both of you into account. An evaluation can tell you which situation you’re in, and it’s often reassuring.
Can I take medication for palpitations while pregnant?
Most palpitations do not need medication. When treatment is needed, some options are considered safe in pregnancy, and the choice depends on your rhythm, your health, and how far along you are. Talk to your care team before starting or stopping anything.
Reach out when something feels off
A heartbeat you can feel is not automatically a problem, and you do not have to figure this out alone. If your palpitations are new, frequent, or worrying you, a cardiology visit can give you clear answers and peace of mind.
Sources
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This content is for general informational purposes only and is not medical advice. Talk with your healthcare provider before making any decisions about your health.
