Key Takeaways
- During pregnancy, most patients will experience higher blood volume, heart rate, cardiac output, and lower blood pressure early on.
- Heart palpitations are common in pregnancy and usually linked to the increase in blood volume and heart rate.
- If patients have high blood pressure after 20 weeks or the lasting feeling of a racing heart, contact your OBGYN provider.
During pregnancy, patients experience a range of health changes in their bodies – including their heart.
Blood pressure, heart rate, hormones, and cardiac output all change significantly throughout the course of pregnancy, according to research. For the health of both the parent and baby, prioritizing heart health is vital.
Maranda Sullivan, DO, is a maternal fetal medicine physician with Rochester Regional Health, an OBGYN provider who specializes in high-risk pregnancies. She answers questions that patients have about heart health and pregnancy.
Normal heart changes during pregnancy
At the start of pregnancy, the body needs to provide nutrients and sustenance to sustain the fetus and the person who is pregnant. As a result, the cardiovascular system changes in several important ways, including:
- increased blood volume
- increased heart rate
- increased cardiac output
- decreased blood pressure
These changes often start in the first weeks of the first trimester and are very likely to go away after delivery.
“There is quite a bit of strain on the heart during pregnancy,” Dr. Sullivan said. “A pregnant person’s heart rate and blood volume significantly increase during pregnancy, sometimes by up to 50 percent.”
Common heart concerns during pregnancy
Palpitations
Palpitations are the most common heart-related concern that comes up for patients, according to Dr. Sullivan. They can feel different for patients; some feel more of a fast heart rate, while others feel skipping beats or a flip-flopping sensation.
The normal increase in blood volume and heart rate that pregnant people experience are the most common underlying factors in heart palpitations.
For most patients, heart palpitations are normal. However, if you experience them, it is still important to bring them up with your provider. For a small number of patients, palpitations can be a sign of underlying cardiac issues such as arrhythmias.
“Heart palpitations are variable depending on the patient,” Dr. Sullivan said. “They can present at any point during pregnancy. Because the blood volume increases early on in pregnancy, they don’t preferentially show up at later gestational ages compared to earlier.”
Preeclampsia
Preeclampsia most commonly occurs in the 3rd trimester after 20 weeks. It is usually characterized by high blood pressure (140/90 mm/Hg or higher) and, if left untreated, can cause serious complications for both the patient and baby.
Pregnant patients with preeclampsia can experience
- higher blood pressure
- protein in the urine
- headaches or vision changes
- kidney and liver function changes
Patients are at a higher risk for preeclampsia if they have
- existing cardiovascular disease, including high blood pressure
- family history of preeclampsia
- diabetes
- obesity
At-home doppler use
Doppler devices are used to listen to a baby’s heartbeat during pregnancy and don’t pose any risk of physical harm to the fetus.
For patients, using these devices can decrease their anxiety – especially depending on their obstetrics history.
However, for someone without medical training, the baby’s heart rate can be hard to find, and placenta blood flow can be confused for fetal heart rate. Both of these limitations can cause increased anxiety for patients.
“It is helpful to have the conversation with each patient to explain the use of these devices and what their limitations are,” Dr. Sullivan said.
When to talk with your OBGYN about heart concerns
If a patient feel like their heart is racing fast and the feeling does not go away, that is an indication that they need to be seen by their OBGYN sooner than later.
Patients who have a cardiologist prior to becoming pregnant should continue to follow up with them throughout their pregnancy, as well.
Dr. Sullivan also encourages patients to attend preconception counseling. During these appointments, patients can share their current health concerns with their provider and have them addressed before they become pregnant.
“If patients know their family history, have any blood pressure issues or heart defects, preconception counseling is an excellent way to have those concerns addressed before becoming pregnant,” Dr. Sullivan said. “Because pregnancy increases heart-related health risks, patients can take steps ahead of time to mitigate those risks.”
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