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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment and reassurance for the gradual, exertion-related breathlessness, occasional palpitations and both-sided ankle swelling that are normal in pregnancy, with blood tests, home blood pressure monitoring and asthma reviews arranged; sudden breathlessness, chest pain, one-sided leg swelling or pre-eclampsia signs are never managed online.
- What they are: symptoms from a circulation working far harder than usual: blood volume up by nearly half, resting pulse up 10 to 20 beats, deeper breathing; the complications are clots, about 1 in 1,000 pregnancies, pre-eclampsia in about 1 in 20, and rare heart muscle weakness.
- Clot signs: a swollen, painful, warm or red calf or thigh, usually one-sided and most often the left leg, needs an urgent scan at the maternity unit; the same with sudden breathlessness, chest pain or coughing blood means a clot in the lungs and a 112 call.
- Pre-eclampsia: high blood pressure with protein in the urine after 20 weeks, often silent, which is why every antenatal visit checks both; severe headache, visual disturbance, pain under the right ribs, sudden face and hand swelling, or vomiting after 20 weeks needs the maternity unit.
- Normal pattern: breathlessness that builds gradually with exertion and eases with rest, brief flutters or skipped beats, both ankles swelling by evening and draining overnight, and light-headedness on standing are expected in pregnancy, peaking around 30 to 34 weeks.
- Emergency: call 112 for sudden breathlessness, chest pain, coughing blood, a seizure, collapse, or breathlessness at rest or lying flat with a racing pulse, and say you are pregnant.
Do not book an online consultation for these. Sudden breathlessness, chest pain, coughing blood, or collapse: call 112 now, these can be a pulmonary embolism or heart emergency. A swollen, painful or hot calf, usually one-sided, needs urgent hospital assessment for a clot. Severe headache, vision changes, pain under the ribs or sudden swelling of your face and hands after 20 weeks: contact your maternity unit urgently, these are pre-eclampsia signs. A seizure in pregnancy is always 112.
Can an online doctor help with heart and lung symptoms in pregnancy?
An online doctor can help sort the expected breathlessness, ankle swelling, dizziness and varicose veins of pregnancy from the warning signs of blood clots, pre-eclampsia and heart problems, and can advise on the everyday symptoms once red flags are excluded. The dangerous presentations, including sudden breathlessness, chest pain and one-sided leg swelling, need emergency or same-day hospital care, not a video call.
That is a narrower promise than on most condition pages, and it is deliberate. Pregnancy changes the circulation profoundly: blood volume rises by almost half, the heart works harder, hormones relax blood vessel walls, and blood clots more readily, a protective adaptation for birth with a known cost, a higher risk of deep vein thrombosis and pulmonary embolism through pregnancy and the weeks after delivery.[2][4] Most symptoms this produces are benign. A few are among the leading causes of serious harm in pregnancy, which is why this page leads with recognition rather than reassurance.
What is treated online for heart and lung problems in pregnancy, and what needs in-person care
Usually handled online: the benign, pattern-true symptoms of a hard-working pregnant circulation.
- Dizziness and faintness: positional patterns explained and managed
- Swelling (oedema) in pregnancy: evening ankle swelling assessed and eased
- Varicose veins in pregnancy: compression, elevation and honest expectations
Assessed online, but often needs in-person or urgent care: four pages in this section are recognition guides first, because their dangerous causes cannot be excluded by video.
- Breathing problems in pregnancy: gradual breathlessness is reviewed online, but sudden breathlessness is a 112 call for possible pulmonary embolism
- Deep vein thrombosis in pregnancy: one-sided leg swelling or pain needs a same-day hospital scan, never a video diagnosis
- Heart issues in pregnancy: chest pain, fainting or breathlessness at rest needs an ECG and in-person tests
- High blood pressure in pregnancy: readings and pre-eclampsia checks belong with your maternity team
Pages in this section
Which heart and lung symptoms are normal in pregnancy?
Gradual, mild breathlessness on exertion is one of pregnancy's most common experiences: hormones drive you to breathe more deeply from early on, and later the growing uterus leaves the lungs less room. Ankle and foot swelling that affects both sides, builds through the day and eases overnight is equally ordinary, as are visible varicose veins, occasional skipped or extra heartbeats, and feeling faint when standing quickly or lying flat on your back, which lets the uterus press on the large vein returning blood to the heart.
The pattern is what separates normal from notable: normal symptoms come on gradually, track with exertion, position or the time of day, and settle with rest or a change of position. Symptoms that arrive suddenly, at rest, on one side, or with pain break that pattern, and pattern-breaking is precisely what a video consultation can establish quickly, because it lives in the history rather than the examination.
How do I tell normal swelling from a clot or pre-eclampsia?
Location and speed. Normal pregnancy swelling is both ankles, slow, painless and better each morning. A deep vein thrombosis is typically one leg, most often the left, with swelling, pain, warmth or colour change in the calf, and it needs same-day hospital assessment because part of a clot can travel to the lungs.[2] If that happens, a pulmonary embolism, the signs are sudden breathlessness, chest pain that is worse on breathing in, coughing blood, or collapse, and the response is 112, immediately, every time.[3]
Pre-eclampsia swells differently: face and hands, arriving suddenly, typically after 20 weeks, in company with severe headache, visual disturbance such as flashing lights, pain under the ribs, or simply feeling abruptly unwell. It is a blood pressure disorder of pregnancy that can escalate quickly, which is why those symptoms mean urgent maternity assessment and blood pressure measurement rather than watchful waiting.[1] High blood pressure found at an antenatal check belongs with your maternity team even when you feel perfectly well; the high blood pressure in pregnancy guide explains what the numbers mean and how monitoring works.
Online care or urgent care for heart and lung symptoms?
This table is the page's core message. When in doubt, take the urgent column.
Swipe sideways to compare →
| Situation | Likely first step | Suitable for online care? | Where to go instead |
|---|---|---|---|
| Gradual mild breathlessness on exertion, otherwise well | History review to confirm the benign pattern | Usually yes | In-person review if it arrives suddenly or at rest |
| Both ankles swelling by evening, easing overnight; varicose veins | Compression, elevation and movement advice | Yes | Same-day review if swelling becomes one-sided or painful |
| Feeling faint on standing or lying flat; brief fluttering palpitations | Pattern review and practical advice; further checks if frequent | Often yes | In-person tests for palpitations with fainting, chest pain or breathlessness |
| One-sided calf swelling, pain, warmth or colour change | Same-day hospital assessment for suspected DVT[2] | No | Maternity unit or emergency department today |
| Sudden breathlessness, chest pain, coughing blood, severe headache with vision changes, or collapse | Emergency care[1][3] | No | Call 112 now |
On the everyday side of the table, but still unsure? A doctor can tell you in one consultation.
See available times →What the doctors help with here
- Recognition and routing, first and always: a deliberate red-flag screen for clots, pre-eclampsia and cardiac symptoms before anything else is discussed.
- The benign majority, properly explained: why you are breathless on stairs, why your ankles swell, why lying on your back makes you faint, and what actually helps.
- Varicose veins and swelling plans: compression, elevation, movement and sleep positions, with honest expectations about what resolves after birth.
- Blood pressure sense-making: what your antenatal readings mean, how to measure correctly at home if asked to, and which numbers or symptoms mean calling your maternity unit.
- Clot risk awareness: understanding personal risk factors such as immobility and long journeys, and the leg and breathing symptoms that must never be slept on.
When you need maternity services instead
You are directed out of online care, immediately and explicitly, for suspected DVT, meaning one-sided leg swelling, pain, warmth or colour change; any sudden breathlessness, chest pain or coughing of blood, which is a 112 call for possible pulmonary embolism; pre-eclampsia symptoms, meaning severe headache, visual disturbance, pain under the ribs, sudden face or hand swelling, or raised readings, which go urgently to your maternity unit; palpitations with fainting, chest pain or breathlessness, which need an ECG; and any seizure, which is 112. In these situations an online consultation is not offered as a first step, because the honest first step is a hospital, and no consultation fee should ever sit between you and it. If your doctor decides you need to be seen in person, you get a full refund and clear directions to the right care. The wider category overview lives at pregnancy-related conditions.
When to get in-person care
Call 112 now for sudden breathlessness, chest pain, coughing blood, a seizure, or collapse. Go to your maternity unit or an emergency department today for one-sided calf swelling, pain or warmth. Contact your midwife or maternity unit urgently for severe headache, vision changes, pain under the ribs, sudden swelling of your face or hands, or a change in your baby's movements. None of these should ever wait for an online appointment.
What your heart and lungs are actually doing in pregnancy
By the third trimester your blood volume has grown by roughly half, your heart pumps noticeably more with every beat, and your breathing moves more air even at rest. These are healthy adaptations, but they explain almost everything this section deals with: the pounding you notice lying on your left side, the breathlessness on stairs that used to be nothing, the swollen ankles at day’s end and the visible veins.
The same adaptations also explain why doctors take small signals seriously. A system running this close to its design limits has less spare capacity, so a clot, rising blood pressure or true heart strain shows itself faster. That is why every page in this section draws the same line: gradual, position-dependent and settling with rest usually belongs to healthy adaptation; sudden, progressive or accompanied by pain, faintness or one-sided leg swelling belongs in front of a doctor the same day.
Bring specifics to any consultation: what you were doing when it happens, how long it lasts, and what ends it. Patterns diagnose better than adjectives here.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about heart and lung problems in pregnancy: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
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Not sure which page fits? Tick every symptom you have to see each page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call. If you have an emergency sign listed on this page, call 112 instead.
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Not sure this is the right page? Look up any symptom in the full symptom checker, or book and describe it to a doctor.
Frequently asked questions about heart and lung problems in pregnancy
What does pregnancy do to the heart and lungs, and what symptoms does that cause?
From the first weeks, blood volume climbs by 40 to 50%, the heart pumps 30 to 50% more each minute and beats 10 to 20 times faster at rest, blood vessels relax so blood pressure dips in mid-pregnancy, progesterone drives deeper breathing, and the womb lifts the diaphragm by several centimetres. The normal results are breathlessness on exertion, awareness of the heartbeat, light-headedness on standing, ankle swelling and a sense of needing more air.
Which heart and lung symptoms are normal in pregnancy, and which are not?
Normal: gradual breathlessness with stairs or hurrying that eases with rest, occasional brief palpitations, both-sided ankle and foot swelling worse by evening, light-headedness when standing quickly or lying flat late on. Not normal: breathlessness that is sudden, at rest or lying flat, chest pain, coughing blood, fainting, a racing pulse that does not settle, one-sided leg swelling or pain, sudden face and hand swelling, severe headache or visual disturbance after 20 weeks.
Can an online doctor assess breathlessness or swelling during pregnancy?
Yes, when it fits the gradual, exertion-related pattern that is normal in pregnancy: the doctor reviews your history by video, confirms the pattern, screens for the warning signs, directs a blood count for anaemia and blood pressure checks, and reviews asthma treatment where relevant. Sudden breathlessness, chest pain, one-sided swelling or pre-eclampsia symptoms are directed to 112 or the maternity unit at once, because they need examination and tests.
Why are blood clots more likely in pregnancy?
Blood clots more readily in pregnancy, a natural preparation for the bleeding of birth, while the growing womb slows blood returning from the legs, especially the left, and activity falls; together these raise clot risk about fivefold, to roughly 1 in 1,000 pregnancies, and the first six weeks after birth are the riskiest window. Previous clots, thrombophilia, obesity, smoking, twins, a caesarean and long travel add to it; heparin prevents clots at higher risk.
What are the warning signs of pre-eclampsia?
Severe headache that painkillers do not ease, vision changes such as flashing lights or blurring, pain just under the ribs especially on the right, sudden swelling of the face, hands or feet, vomiting after 20 weeks, and feeling suddenly very unwell; often there are no symptoms, which is why blood pressure and urine are checked at every antenatal visit. Pre-eclampsia affects about 1 in 20 pregnancies and needs the maternity unit without delay.
Are palpitations normal when pregnant?
Occasional brief flutters, thumps or skipped beats are common in pregnancy because the heart is working harder and is more sensitive to caffeine, tiredness, anxiety and anaemia, and they are usually harmless. Palpitations that come with chest pain, breathlessness, faintness or fainting, that start and stop abruptly and last minutes, or that run at a sustained fast rate need an ECG and an in-person assessment; the rest get a blood count and thyroid test.
Is it safe to fly during pregnancy, and does flying raise my clot risk?
For most uncomplicated pregnancies flying is considered safe, though airlines set their own limits in late pregnancy and ask for a letter after about 28 weeks, so check before booking. Flights over four hours raise clot risk, more so in pregnancy: wear fitted compression stockings, walk the aisle and flex your ankles hourly, drink water, avoid alcohol, and ask the doctor about heparin injections if you have extra risk factors or a previous clot.
How do I tell normal pregnancy breathlessness from something serious?
Normal pregnancy breathlessness builds gradually, appears on exertion or when the bump crowds your lungs, eases with rest and position changes, and does not stop you speaking in sentences. Serious breathlessness comes on suddenly or at rest, wakes you lying flat, comes with chest pain, coughing blood, a racing pulse, fainting or one-sided leg swelling, or follows a rapid decline over days; that pattern is a clot or heart problem until proved otherwise: call 112.
How long do heart and lung symptoms last in pregnancy?
Normal breathlessness and palpitations build through the second trimester, peak around 30 to 34 weeks, ease when the baby drops into the pelvis and settle within days to weeks of the birth; ankle swelling peaks in the last month and drains within a week or two of delivery; the raised pulse and blood volume return to normal over about six weeks. Clot risk stays raised for six weeks after birth, as does pre-eclampsia.
What can I do myself about heart and lung symptoms in pregnancy?
Pace exertion and rest when breathless, sleep propped up on your left side, sit with good posture to give the lungs room, stand up slowly and avoid long standing, drink enough and eat regularly to prevent faintness, keep active with walking or swimming, elevate your legs and wear support stockings for swelling, cut caffeine for palpitations, do not smoke, take any prescribed iron, and check your blood pressure at home if asked.
How can heart and lung problems in pregnancy be prevented?
Prevent clots by staying active, hydrated and at a healthy weight, wearing compression stockings on long journeys and taking heparin if prescribed; prevent pre-eclampsia complications by attending every antenatal check and, if you are at higher risk, taking low-dose aspirin from 12 weeks as advised; prevent anaemia-driven breathlessness with iron-rich food and treatment when tests show deficiency; and keep asthma controlled with preventer inhalers. Knowing the warning signs prevents delay, which matters most.
I have an existing heart condition. How is pregnancy managed?
Most women with a heart condition, such as congenital heart disease, a valve problem, a previous cardiomyopathy or an arrhythmia, have safe pregnancies with joint care from obstetric and cardiology specialists, ideally planned before conception because some heart medicines need changing and a few conditions carry high risk. The extra workload peaks in the second trimester and around delivery, when monitoring is closest; the plan belongs to the specialist team.
Is it normal swelling, a clot or pre-eclampsia?
Normal swelling is both ankles and feet, builds through the day, drains overnight and is painless. A clot is usually one leg, often the left, swollen, painful, warm or red, with the calf tender, and needs an urgent scan. Pre-eclampsia swelling arrives suddenly, over hours, in the face, around the eyes and in the hands, with headache, visual change or pain under the ribs after 20 weeks, and needs the maternity unit.
- Hypertension in pregnancy: diagnosis and management (NG133), NICE, National Institute for Health and Care Excellence, 2019 (updated 2023).
- Deep vein thrombosis, NICE CKS, Clinical Knowledge Summaries, reviewed 2024.
- Pulmonary embolism, NICE CKS, Clinical Knowledge Summaries, reviewed 2024.
- ESC Guidelines for the management of cardiovascular diseases during pregnancy, ESC, European Society of Cardiology, 2018.
- Pre-eclampsia, NHS, National Health Service (UK), reviewed March 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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