Heart Palpitations in Pregnancy
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Heart palpitations in pregnancy are sensations that make you aware of your heartbeat, often feeling like pounding or racing [1]. They are extremely common, especially in the third trimester, as blood volume rises and the heart works harder [1]. They are rarely dangerous and usually resolve after childbirth [1], but chest pain, trouble breathing or severe dizziness need immediate evaluation [1].
What the research says
Extra heartbeats are common in healthy pregnancies, and symptoms don't always match the rhythm. In a study of 110 pregnant women without heart disease who were referred for palpitations, dizziness, or fainting, and 52 referred for an asymptomatic heart murmur, 24-hour Holter monitoring found extra beats from the upper chambers (atrial premature complexes) in 56% and 58% of the two groups. Only about 10% of symptomatic episodes coincided with an arrhythmia, and in 9 women re-tested 6 weeks after delivery, premature beats fell from about 9,073 to 1,345 per 24 hours (Shotan et al., American Journal of Cardiology, 1997) [2].
Monitoring can uncover an arrhythmia, even without a heart history, but treatment changes are modest. In a retrospective study of 111 pregnant patients referred to an obstetric cardiology clinic for palpitations, 61 (55%) had ambulatory cardiac monitoring and arrhythmias were detected in 28 of them (46%), including patients with no prior cardiac history. Beta-blockers were started or continued in 7 of those 28 (25%), and the authors concluded that the therapeutic yield was modest and supports a selective monitoring approach (Navya et al., American Heart Journal Plus, 2026) [3].
A confirmed arrhythmia is different from harmless palpitations and deserves follow-up. A systematic review and meta-analysis of 19 cohort and case-control studies found that pregnant women with a diagnosed cardiac arrhythmia had higher risks of preeclampsia (relative risk 1.46), preterm delivery (1.39), and stillbirth (2.09) than women without one, and the authors call for enhanced surveillance (Siargkas et al., Healthcare, 2026) [4].
Key Takeaways
Feature | Description |
Common Sensations | Fluttering, racing, pounding, or skipped beats [1]. |
Primary Causes | Increased blood volume (almost 50%) and hormonal shifts [1]. |
Lifestyle Triggers | Caffeine, stress, dehydration, and high-carb, high-sugar, or high-fat meals [1]. |
Medical Factors | Anemia, thyroid issues, and underlying arrhythmias [1]. |
Diagnostics | Blood tests (such as a CBC), EKGs, and Holter monitors [1]. |
Management | Hydration, relaxation techniques, and limiting stimulants [1]. |
Symptoms and Sensations
Pregnant people may experience palpitations in several distinct ways, which can vary in intensity and frequency throughout the trimesters.
Fluttering and Flips
Many people describe a "flapping" or "fluttery" feeling in the chest [1], often likening it to the heart "doing flips." This sensation is common when the heart experiences a premature beat followed by a more forceful contraction.
Irregular Heart Rate
Palpitations can feel like the heart is skipping a beat, beating out of rhythm, or suddenly speeding up and then slowing down. Some people report a brief sensation in which the heart seems to stop for a second or two before resuming its normal pace [1].
Forceful Pounding
A pounding heart feels like the organ is beating very hard against the chest wall. This is often more noticeable when resting or in a quiet environment, and some people may even hear the heartbeat in their ears [1].
Why Palpitations Occur During Pregnancy
The body undergoes major cardiovascular changes to support a growing fetus, which naturally places more demand on the heart.
Increased Blood Volume
Over the course of a pregnancy, blood volume increases by almost 50% [1]. This requires the heart to work significantly harder and pump more blood throughout the body and to the fetus, often leading to a higher resting heart rate and occasional palpitations [1].
Hormonal Shifts
Fluctuations in hormones, particularly estrogen, can affect the heart's electrical system and sensitivity, making palpitations more likely to occur during various stages of pregnancy [1].
Common Triggers and Risk Factors
While the physiological changes of pregnancy are the primary cause, several external and internal factors can make palpitations more likely.
Common Lifestyle Triggers
Stimulants: Caffeine in coffee and chocolate is a frequent trigger [1]. Nicotine and alcohol should also be avoided during pregnancy [1].
Dietary factors: Meals high in carbohydrates, sodium, sugar, or fat can cause a temporary racing heart [1].
Dehydration: A lack of fluids and electrolyte imbalances can disrupt the heart's normal rhythm [1].
Stress and anxiety: Psychological pressure can trigger the "fight or flight" response, leading to palpitations [1].
Potential Medical Causes
In some cases, palpitations are linked to an underlying health condition:
Anemia: A low red blood cell count is common in pregnancy [1] and can make the heart pump faster to circulate oxygen.
Thyroid disorders: Conditions such as hyperthyroidism can cause a persistent racing heart [1].
Arrhythmias: Pre-existing or new-onset heart rhythm problems such as atrial fibrillation (Afib) [1].
Low blood pressure or low blood sugar: Both can trigger episodes, and low blood sugar is more common in the first trimester [1].
Diagnosis and Safety
Healthcare providers use safe, non-invasive methods to make sure palpitations are not a sign of a more serious issue.
Test | Purpose |
Complete Blood Count (CBC) | Checks for anemia, infections, and vitamin deficiencies [1]. Your provider may also order blood tests for thyroid problems. |
EKG (Electrocardiogram) | A quick, safe test, usually about 15 minutes, that measures heart rate and the heart's electrical activity [1]. |
Holter Monitor | A wearable device that records your heart rhythm during daily activities, worn for up to two weeks, if an EKG does not catch an episode [1]. |
Management and Relief Strategies
Most pregnancy-related palpitations can be managed with lifestyle adjustments and simple at-home techniques.
Immediate Self-Care
Hydration: Staying well hydrated is crucial [1] because the body needs extra fluids to support both you and your baby.
Relaxation techniques: Slow, deep breaths, pursed-lip breathing, or meditation [1] can help calm the nervous system during an episode.
Rest and positioning: Taking a break and changing your position may help an episode settle.
Long-Term Prevention
Balanced nutrition: Focus on a diet low in excess sugar and sodium while getting enough iron to help prevent anemia.
Limit caffeine: Stick to one cup of coffee a day or less [1], and keep an eye on other caffeinated products.
Professional guidance: If an underlying condition is found, your provider will build a treatment plan that is safe for you and your baby, which may include medicines such as beta blockers [1].
Outlook and When to Seek Help
The outlook for heart palpitations in pregnancy is excellent, and most cases resolve after delivery [1]. However, tell your provider about your symptoms, and get help right away if you have palpitations along with:
Conclusion
Heart palpitations are a very common and usually benign part of the pregnancy experience. While the physical demands of supporting a new life can cause the heart to race or pound, most people find that these sensations are temporary and manageable through simple lifestyle changes. By staying hydrated, reducing stress, and keeping up with regular prenatal care, you can support a healthy environment for both yourself and your growing baby.
Frequently Asked Questions
What are heart palpitations in pregnancy?
They are sensations of a pounding, racing, or fluttering heart during pregnancy.
Are they dangerous?
Most are harmless and result from normal pregnancy changes.
Why do they happen?
Mainly because blood volume rises by almost 50% and the heart works harder.
When are they most common?
They often become more frequent in the third trimester.
Can hormones cause them?
Yes, shifts in estrogen can trigger irregular heartbeats.
Is caffeine a trigger?
Yes, coffee and chocolate are common stimulants that can cause palpitations.
Does anemia cause a racing heart?
Yes, a low red blood cell count (anemia) can make the heart pump faster.
Can stress affect my heart rate?
Yes, anxiety and stress are significant triggers for palpitations.
Is dehydration a factor?
Yes, staying hydrated helps keep your heart rhythm steady.
Can I hear my heart in my ears?
Yes, some people hear their pounding heart in quiet rooms.
What does "fluttering" feel like?
Like your heart is doing flips or flapping in your chest.
Can sugar cause palpitations?
Yes, high-sugar meals can trigger a temporary racing heart.
Is alcohol safe?
No. Alcohol can harm your baby and can trigger palpitations, so avoid it during pregnancy.
Is nicotine a trigger?
Yes. Smoking can harm your baby and raise the risk of palpitations. Ask your provider for help with a plan to quit.
Can low blood sugar cause them?
Yes, low blood sugar (hypoglycemia), especially in the first trimester, can be a trigger.
Is low blood pressure common?
Yes, low blood pressure (hypotension) is common in pregnancy and can cause palpitations.
What is an EKG?
A safe test that measures the heart's electrical activity.
Is an EKG safe for the baby?
Yes, it is a non-invasive and safe procedure during pregnancy.
What is a Holter monitor?
A device you wear during daily activities to record your heart rhythm, for up to two weeks.
Can extra weight increase the risk?
Yes, carrying extra weight before and during pregnancy raises the risk of an irregular heartbeat and other heart problems.
Are thyroid problems a cause?
Yes, hyperthyroidism can lead to a fast heart rate.
What is Afib?
Atrial fibrillation, a type of irregular heart rhythm.
Can heart failure happen in pregnancy?
It is rare but possible, and palpitations can be a sign.
What is myocarditis?
Inflammation of the heart muscle, often from a viral infection.
Can valve disease cause palpitations?
Yes, structural heart problems such as valve disease are a possible cause.
Do palpitations require treatment?
Most do not, unless an underlying medical condition is found.
What are beta blockers?
Medicines your provider may prescribe to slow the heart rate when needed, after weighing the benefits and risks for you and your baby.
How can I stop an episode?
Try slow, deep breaths, drinking water, or changing position.
What is pursed-lip breathing?
A breathing technique that helps calm the heart and nervous system.
Does meditation help?
Yes, it can reduce the stress that triggers palpitations.
Should I avoid salt?
Limiting high-sodium foods can help.
Can I exercise?
Usually yes, but ask your provider what level of activity is right for you.
How long do they last?
Most last only a few seconds or minutes.
Do they go away after birth?
They typically resolve after delivery.
When should I call my doctor?
If they are frequent or long-lasting, or come with chest pain, trouble breathing, or dizziness.
Can palpitations cause fainting?
They can, and fainting needs immediate medical help.
Is a racing heart the same as a palpitation?
A racing heart is one common way people describe palpitations.
Can decongestants cause them?
Yes, some cold medicines contain stimulants. Check with your provider before taking any.
What is tachycardia?
The medical term for a heart rate over 100 beats per minute.
Is a CBC test necessary?
It helps rule out anemia and other problems, but your provider decides which tests you need.
What if my heart skips a beat?
This is often a harmless premature beat (a PVC or PAC), but mention it at your next visit.
Can I prevent them entirely?
You may not be able to, but you can lower your risk by managing triggers.
Are they more common in twin pregnancies?
Twin pregnancies place even greater demands on the heart, so tell your provider about any palpitations.
Can an electrolyte imbalance cause them?
Yes, minerals such as potassium help control your heart rhythm.
Should I tell my midwife?
Yes, always report palpitations at your prenatal visits.
Can high-fat foods be a trigger?
Yes, heavy meals can sometimes cause a racing heart.
Is a pounding heart dangerous?
Not usually, but it can be unsettling.
Can I sleep on my back?
Side sleeping is usually recommended to improve circulation.
Do they affect the baby?
Benign palpitations do not typically affect the fetus.
Can heart palpitations be cured?
Most resolve on their own once the body returns to its pre-pregnancy state.
Related Reading
Heart Palpitations: Causes, Symptoms & Treatment Guide explains common causes of palpitations and when to get checked.
Heart Disease & Pregnancy: Managing Risks for a Healthy Journey covers heart conditions in pregnancy and how they are managed.
Anemia During Pregnancy: What It Is, Why It Happens, and How Iron, Vitamins, and Treatment Protect You and Your Baby explains low iron in pregnancy, a possible cause of a racing heart.
What Is Supraventricular Tachycardia (SVT)? Symptoms, Causes, Tests, and Treatments Explained explains a fast heart rhythm that can first appear during pregnancy.
References
Cleveland Clinic. Heart Palpitations in Pregnancy. Cleveland Clinic. Last updated October 1, 2021. https://my.clevelandclinic.org/health/diseases/21941-heart-palpitations-in-pregnancy
Shotan A, Ostrzega E, Mehra A, et al. Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness, and syncope. American Journal of Cardiology. 1997;79(8):1061-1064. PMID 9114764. https://doi.org/10.1016/s0002-9149(97)00047-7
Navya A, Ramy Z, Devansh P, et al. Evaluation of palpitations in pregnancy using an ambulatory event monitor. American Heart Journal Plus: Cardiology Research and Practice. 2026;64:100740. PMID 41853613. https://doi.org/10.1016/j.ahjo.2026.100740
Siargkas A, Arvanitaki A, Faka A, et al. Association of maternal cardiac arrhythmias with pregnancy outcomes: a systematic review and meta-analysis. Healthcare (Basel). 2026;14(8). PMID 42072894. https://doi.org/10.3390/healthcare14080993
Disclaimer
The information provided in this article is for educational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of any health condition during pregnancy.
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