On this page
Dr. Chrysoula I. Liakou MD, PhD
Call 112 now, or go straight to your maternity unit, if any of these apply
Call 112 immediately, and do not drive yourself, if you are pregnant or recently gave birth and you have:
- chest pain, pressure, squeezing or heaviness, especially if it spreads to your arm, jaw, neck or back, or comes with sweating or nausea;[4]
- severe breathlessness at rest, breathlessness that wakes you at night, or being unable to lie flat without gasping;
- fainting or collapse, particularly during exertion, or palpitations that come with fainting, near-fainting or chest pain;
- sudden sharp chest pain with breathlessness, or coughing up blood, especially if one calf is also swollen or painful (possible lung clot);
- a racing heartbeat that will not stop and is making you feel unwell, faint or breathless.
Contact your maternity unit or midwife urgently the same day if you have new breathlessness on mild activity that is clearly worsening, new swelling with a severe headache or vision changes (possible pre-eclampsia, which has its own warning signs), or a known heart condition and any new or worsening symptom.[3] Calling 112 for symptoms that turn out to be harmless is the correct use of 112; pregnancy is exactly when nobody should wait and see.
- Treated online: Assessment only: a structured history of palpitations or a racing pulse without red flags, with blood tests for anaemia and thyroid directed and an ECG arranged where needed; chest pain, breathlessness at rest, fainting or sustained fast palpitations are never managed online.
- What it is: the strain of a circulation working 30 to 50% harder from the first trimester: occasional palpitations affect most pregnant women and are usually benign; true heart disease complicates about 1 to 4 in 100 pregnancies in Europe, mostly in women with a known condition.
- Red flags: chest pain, breathlessness at rest or lying flat, fainting or near-fainting, palpitations that start and stop abruptly and run fast for minutes, a pulse persistently over 120 at rest, a new night cough with swelling, or blue lips; any of these means 112.
- Cardiomyopathy: peripartum cardiomyopathy, a weakness of the heart muscle, affects about 1 in 2,000 pregnancies in Europe, appearing in the last month or the months after birth with breathlessness lying flat, a night cough, swelling and exhaustion; an echocardiogram diagnoses it and most hearts recover.
- Known conditions: most women with congenital heart disease, a valve problem, a previous cardiomyopathy or an arrhythmia have safe pregnancies with joint obstetric and cardiology care planned before conception, when some heart medicines are changed; a few high-risk conditions need specialist advice before trying.
- Emergency: call 112 for chest pain, breathlessness at rest, fainting, palpitations with faintness or breathlessness, or collapse, and say you are pregnant; known heart conditions have an agreed plan for whom to call.
A video consultation is appropriate only when none of the emergency features above apply. If you have a known heart condition (congenital heart disease, a valve problem, a previous cardiomyopathy or arrhythmia), your pregnancy should be looked after jointly by obstetric and cardiology specialists; an online doctor can explain, check symptoms and route you, but never replaces that team.
Are heart palpitations normal in pregnancy?
Usually, yes. In pregnancy, blood volume rises by up to half, the heart pumps more with every beat, and the resting pulse runs faster, so brief flutters, skipped beats and pounding after stairs are common and usually harmless.[1] Palpitations with chest pain, breathlessness or fainting are the exception and need urgent in-person assessment.
How an online consultation helps with heart problems in pregnancy
- Sorting normal from not: the doctor knows what a healthy pregnant heart feels like from the inside (faster, louder, more noticeable) and matches your story against the patterns that genuinely need tests.
- Emergency screening first: every consultation about the heart in pregnancy starts with the red-flag list above, and if your answers change the picture mid-call, the doctor stops and sends you to 112 or your maternity unit there and then.
- The right test, not every test: if you need an ECG, blood tests for anaemia or thyroid problems, or an echocardiogram, you leave knowing which one, where to get it, and how urgently.
- Specialist honesty: pregnancies with known heart disease belong with a joint obstetric cardiology team. If that is you, the doctor says so plainly and helps you get there, rather than managing something a video call should not manage.
What the doctor checks in an online consultation about heart problems in pregnancy
Palpitations and heart symptoms are assessed through the story first, and the story works well by video. The doctor will typically check:
- The exact pattern: when the sensations started, whether they begin and end suddenly or drift in and out, and whether the beat feels fast and regular, irregular, or like single skipped thumps. Tapping the rhythm out on the desk genuinely helps.
- Red flags, systematically: chest pain, breathlessness out of proportion to pregnancy, fainting or near-fainting, and symptoms during exertion, each asked directly.[2]
- How pregnant you are: the stage changes the differential, from early-pregnancy sinus tachycardia to late-pregnancy breathlessness that needs distinguishing from heart failure.
- Triggers and fuels: caffeine and energy drinks, decongestant cold remedies, salbutamol inhalers, dehydration, standing quickly, and broken sleep.
- Contributing conditions: symptoms of anaemia and thyroid overactivity, both common in pregnancy and both treatable causes of a racing heart; the page on tiredness in pregnancy covers the blood tests that check them.
- Your cardiac history: murmurs mentioned in childhood, congenital heart disease, rheumatic fever, previous pregnancy heart problems, and any family history of sudden unexplained death at a young age, which always raises the bar for testing.[1]
- Anxiety, honestly: panic and a pounding heart travel together in pregnancy. Anxiety is a real diagnosis reached after the cardiac questions, never instead of them.
Why does pregnancy make your heart work harder?
Pregnancy is a cardiovascular training programme nobody signed up for. Blood volume expands substantially from early pregnancy, the heart pumps out considerably more per minute, and the resting heart rate climbs by roughly 10 to 20 beats.[1] Blood pressure often dips in mid-pregnancy before returning towards booking levels. All of this is normal physiology, and it explains why a healthy pregnant woman can feel her heartbeat in bed at night, notice pounding after one flight of stairs, and feel flutters that never troubled her before. Extra, early or skipped beats (ectopics) become more noticeable and more frequent, and in an otherwise well woman with a normal examination they are benign.
Common and usually harmless
Sinus tachycardia (a fast but normal rhythm), occasional ectopic beats, and awareness of a forceful heartbeat are the overwhelming majority of palpitations in pregnancy.[2] They are made worse by caffeine, dehydration, fever, anaemia and anxiety, and better by treating those. They do not need heart medication; they need explanation, which is itself treatment for the worry they cause.
Uncommon but important
A minority of palpitations are true arrhythmias. Supraventricular tachycardia (SVT) can appear for the first time, or worsen, in pregnancy: episodes of a sudden-onset, rapid, regular pounding that stops as abruptly as it starts. It is diagnosable on an ECG and treatable, including during pregnancy, and deserves proper assessment rather than reassurance.[1] Rarer still, and worth naming because early treatment changes everything, is peripartum cardiomyopathy: a weakness of the heart muscle appearing towards the end of pregnancy or in the months after birth.[5] Its signature is breathlessness lying flat or at night, a persistent cough, new swelling, and exhaustion beyond anything expected, and it needs an urgent echocardiogram, not watchful waiting.[1]
Do I need an ECG for palpitations in pregnancy?
Sometimes. An ECG is needed when palpitations are sustained, start and stop abruptly, happen during exertion, or come with chest pain, breathlessness or fainting, and whenever there is known heart disease or a family history of sudden death.[2] Brief occasional flutters in a well woman with none of those features often need no test at all. Be clear about the limit: no video call can record your heart rhythm. What an online doctor does is decide, with you, whether an ECG is needed and how fast, then point you to the nearest right place, which may be your midwife, a local practice or a hospital clinic.
Heart symptoms in pregnancy: what needs which care
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Brief flutters or skipped beats, well in between, no red flags | Explanation, trigger review (caffeine, sleep, hydration), safety-net advice | Usually yes | If episodes become sustained, exertional, or red flags appear |
| Sudden-onset rapid regular pounding lasting minutes, stopping abruptly | ECG and in-person assessment for possible SVT | Initial direction only | Promptly; urgently if faintness or chest pain accompanies it[2] |
| Chest pain, breathlessness at rest, fainting or collapse | Emergency care | No | Call 112 now |
| Breathless lying flat, night cough, new swelling in late pregnancy or after birth | Same-day assessment with echocardiogram (possible peripartum cardiomyopathy) | No | Same day, via maternity unit or emergency care[1] |
| Known heart condition, pregnant or planning pregnancy | Joint obstetric cardiology (pregnancy heart team) review | Explanation and routing only | Throughout pregnancy; ideally starting before conception[1] |
No emergency features, but your heart still will not settle? A doctor can tell you in one consultation.
See available times →Treatment options for heart problems in pregnancy
What you can do yourself
For assessed, benign palpitations: cut caffeine and energy drinks, drink enough through the day, stand up slowly, rest lying on your side rather than flat on your back in later pregnancy, and protect sleep as far as a pregnancy allows. Slow breathing out longer than in settles the adrenaline loop when flutters spike anxiety. Avoid decongestant cold remedies containing pseudoephedrine, which can drive the heart rate and are best avoided in pregnancy anyway; ask a pharmacist or doctor for alternatives.
Prescription treatment
Most palpitations in pregnancy need no heart medication at all. Where a true arrhythmia is confirmed, treatments such as beta-blockers can be used in pregnancy, but they are chosen, started and monitored by specialists as part of obstetric cardiology care, not started over video.[1] What an online doctor can properly do is treat reversible contributors after assessment (for example, iron deficiency confirmed on blood tests), review whether any current medicine is driving symptoms, and organise the referral. Anything that touches the heart in pregnancy is deliberately conservative.
When heart problems are assessed online, and when you need in-person care
Assessed online: palpitations without red flags; flutters and skipped beats that are frightening but benign-sounding; racing hearts with obvious fuels such as caffeine, anxiety, broken sleep or possible anaemia; questions about symptoms already assessed in person; and preparing the right questions before a cardiology appointment.
In-person care: anyone whose answers trip the emergency list, to 112 immediately, including mid-consultation; sudden-start sustained palpitations, to an ECG promptly; breathlessness lying flat, night cough or new swelling, to same-day assessment for possible cardiomyopathy; suspected pre-eclampsia symptoms, to same-day maternity assessment; and every pregnancy with known heart disease, to a joint obstetric cardiology team, ideally before conception when pregnancy is still being planned.[1] Heart symptoms sit alongside the other pregnancy conditions the doctors assess online, always with the same rule: honest routing beats false reassurance.
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 problems in pregnancy: a private video call from anywhere in Europe; the consultation always starts with the emergency checklist, worked through together.
- Get your plan and safety-net advice: a prescription or referral follows when right for you, with clear safety-net advice throughout; if your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
Not sure it’s your heart? 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.
Tap the body — an area or a point — to browse symptoms anywhere
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 problems in pregnancy
Can an online doctor check my heart during pregnancy?
An online doctor can take a structured history of your heart symptoms, screen for red flags, check your pulse rate with you on camera, and tell you whether you need an ECG, blood tests for anaemia and thyroid, a heart monitor or an echocardiogram, arranged locally; benign palpitations are often settled that way. Listening to the heart, an ECG and a scan are in-person, and any red-flag symptom goes to 112 or the maternity unit.
What causes heart symptoms in pregnancy?
The circulation changes themselves: blood volume rises by up to half, the heart pumps more with each beat and the resting pulse climbs 10 to 20 beats, so you notice your heart more. Caffeine, tiredness, anxiety, dehydration, anaemia, an overactive thyroid, low blood sugar and some cold remedies amplify palpitations. Rhythm disorders, valve problems, congenital heart disease and peripartum cardiomyopathy are the true heart problems, and pre-eclampsia strains the heart too.
Which heart symptoms in pregnancy matter?
Palpitations that come with chest pain, breathlessness or faintness; palpitations that start and stop abruptly and run fast for minutes; a resting pulse persistently over 120; breathlessness at rest or lying flat; a new night cough with ankle or face swelling; fainting with exertion; and chest pain that spreads to the arm, jaw or back. Brief flutters at rest, or a faster pulse on exertion that settles, are the normal awareness of a hard-working heart.
Why is my heart racing while pregnant?
Blood volume rises by up to half in pregnancy, the heart pumps more with each beat, and the resting pulse runs roughly 10 to 20 beats faster, so a heart that races on the stairs or after a coffee is doing its job. Anaemia, dehydration, an overactive thyroid, anxiety and decongestant medicines push it further, which blood tests sort out. A resting pulse persistently over 120, or racing that starts abruptly, needs an ECG.
What is peripartum cardiomyopathy?
A rare weakness of the heart muscle that appears towards the end of pregnancy or in the months after birth, affecting about 1 in 2,000 pregnancies in Europe. Warning signs are breathlessness lying flat or on mild exertion, a night cough, new swelling of the legs or face, exhaustion out of proportion, palpitations and a racing pulse, easily mistaken for normal late pregnancy. An echocardiogram diagnoses it, and with treatment most hearts recover.
I have a heart condition and want to get pregnant. What should I do?
See your cardiologist before trying to conceive. Most women with heart conditions can have safe pregnancies, but medicines often need reviewing, some, such as certain blood pressure and anticoagulant tablets, must be changed before pregnancy, and a few conditions carry high enough risk that specialist advice comes first. The pregnancy is then looked after jointly by obstetric and cardiology teams, with closer monitoring in the second trimester and around delivery, when the heart's workload peaks.
When should I worry about palpitations in pregnancy?
Worry, and act, when palpitations come with chest pain, breathlessness, fainting or near-fainting, when they start and stop abruptly and last minutes, when the pulse is persistently over 120 at rest, or when you have a known heart condition. Brief flutters, thumps and skipped beats, especially after caffeine, a poor night or stress, are common in pregnancy and usually harmless; the doctor checks blood count and thyroid, and arranges an ECG if they are frequent.
Do I need an ECG for palpitations in pregnancy?
Not always. Brief, occasional flutters with no red flags usually need a blood count and thyroid test rather than an ECG. An ECG, and sometimes a 24-hour monitor, is arranged when palpitations are frequent, last minutes, start and stop abruptly, come with faintness, chest pain or breathlessness, or when you have a known heart problem; an echocardiogram follows if the ECG, a murmur or symptoms of heart failure suggest a structural problem.
How long do heart symptoms last in pregnancy?
Normal palpitations and a faster pulse build through the second trimester, peak around 28 to 34 weeks and settle within a few weeks of the birth as blood volume falls; the heart is back to its pre-pregnancy workload by about six weeks. Symptoms from anaemia or thyroid problems ease once those are treated. Peripartum cardiomyopathy recovers over months with treatment in most women, and heart symptoms that persist or worsen after birth are reassessed.
What can I do myself about heart symptoms in pregnancy?
Cut caffeine and energy drinks, stay hydrated, eat regularly to avoid sugar dips, sleep enough and rest on your left side, pace exertion and keep active with walking or swimming, avoid decongestant cold remedies and stimulants, stop smoking, practise slow breathing when palpitations are anxiety-driven, take any prescribed iron, keep a note of when palpitations happen and how long they last, and learn to count your own pulse so you can report the rate.
How can heart problems in pregnancy be prevented?
The physiological symptoms cannot be prevented, only eased. What prevents harm is planning: pre-conception review for a known heart condition, treating anaemia and thyroid disease when tests find them, controlling blood pressure, not smoking, keeping a healthy weight and keeping active, attending antenatal checks that catch pre-eclampsia, and reporting breathlessness lying flat, a night cough or new swelling in late pregnancy promptly, because cardiomyopathy treated early recovers best.
Does a heart problem affect labour and birth?
For most women with benign palpitations, no: labour and birth proceed normally. For women with a known heart condition, the obstetric and cardiology teams agree a birth plan in advance covering the place of birth, pain relief, whether pushing should be shortened, fluid balance and monitoring, and the days after birth, when fluid shifts strain the heart most; a caesarean is needed only for specific conditions. Breastfeeding is possible with most heart medicines.
Is it a heart problem, anxiety, anaemia or thyroid?
Benign pregnancy palpitations are brief flutters at rest that pass. Anxiety brings a steady fast pulse with tingling, breathlessness and a sense of dread that eases with slow breathing. Anaemia brings palpitations with tiredness, breathlessness and pallor, found by a blood count. An overactive thyroid adds heat intolerance, tremor and weight loss, found by a blood test. A heart rhythm problem starts and stops abruptly, runs fast for minutes, and can cause faintness: ECG.
- 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy, ESC, European Society of Cardiology, 2018.
- Palpitations, NICE Clinical Knowledge Summaries, revised 2024.
- Hypertension in pregnancy: diagnosis and management (NG133), NICE, National Institute for Health and Care Excellence, 2019 (updated 2023).
- Cardiovascular diseases (CVDs) fact sheet, WHO, World Health Organization, 2023.
- Peripartum cardiomyopathy (ORPHA:563), Orphanet, the European rare disease portal, accessed August 2026.
- Heart palpitations, 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.
Related conditions
From the Mobi Doctor podcast
The 10 Most Common Travel Illnesses
The travel illnesses doctors see most often in Europe, and how to handle each one away from home.
Listen · 23 Feb 2026 → Podcast · 13:26How to Stay Healthy on a Long Flight
Practical steps for circulation, hydration and infection risk before, during and after a long flight.
Listen · 23 Feb 2026 → Podcast · 15:41Debunking Gut Health Myths
What the evidence really says about gut health, and the popular claims that do not hold up.
Listen · 23 Feb 2026 →Speak to a doctor about heart problems in pregnancy over video, usually within 15 minutes
Licensed doctors · open daily 7am–11pm CET · exact price before payment
See available times →