Heart Palpitations During Pregnancy

By trimester

Weeks 1–13

1st trimester

Heart rate climbs early in pregnancy, so a racing or fluttery feeling can be one of the first pregnancy sensations you notice, sometimes before you've even missed a period. It's rarely anything to worry about this early, but mention it at your first prenatal visit, especially if it comes with dizziness or fainting.

Weeks 14–27

2nd trimester

This is often when palpitations feel most noticeable, since your blood volume and heart output keep climbing until around the midpoint of pregnancy before leveling off. Cutting back on caffeine and energy drinks, staying hydrated, and eating on a regular schedule can all take the edge off ordinary flutters.

Weeks 28–birth

3rd trimester

Your heart rate and output have usually settled into a steady pattern by now, but a growing uterus, disrupted sleep, and lying flat on your back can still make palpitations feel more noticeable. Call your provider or go in the same day if palpitations show up with chest pain, shortness of breath at rest, severe dizziness, or fainting, and expect the fluttery feeling to ease again within a couple of weeks after delivery.

What does the evidence show for heart palpitations?

• Your blood volume expands quickly in early pregnancy, so your heart beats faster at first and then pumps more blood with each beat, a buildup that keeps going until roughly the midpoint of pregnancy. 1
• Heart flutters get more common as pregnancy goes on, and when researchers tracked pregnant women with palpitations on 24-hour heart monitors, fewer than one in four actually had a detectable rhythm problem. 2
• Extra or skipped heartbeats show up on heart monitors in more than half of healthy pregnant women who notice palpitations, but the feeling itself rarely matches an actual rhythm problem and tends to ease again after delivery. 3
• A single skipped beat now and then is usually nothing to worry about, but feeling faint, very lightheaded, or having a heartbeat that stays wildly irregular for more than a few minutes is different and calls for prompt medical evaluation. 4
• Palpitations paired with shortness of breath are more likely to turn up a real heart finding on testing than palpitations alone, which is why that particular combination is worth calling your provider about right away. 5
• Palpitations arriving with lightheadedness or syncope raise the question of ventricular or supraventricular tachycardia, and palpitations with chest pain may suggest myocardial ischemia, while isolated premature beats alongside an unremarkable exam, EKG, and labs are usually benign. 6

When should I call my provider about heart palpitations?

The fluttering most people notice in pregnancy is brief, turns up at rest or on standing, and passes on its own. What changes the picture is the company it keeps. Palpitations with lightheadedness or fainting raise the question of a fast arrhythmia, and palpitations with chest pain raise the question of reduced blood flow to the heart, so either pairing means being seen the same day rather than waiting it out. A racing or irregular beat that will not settle, or one that arrives with breathlessness you cannot rest off, sits in that same category. Whatever the pattern, any symptom that feels beyond your usual range is a reason to call: obstetric teams expect these questions and would rather hear early than late.