Pregnancy makes the heart work harder - blood volume, heart rate and cardiac output all rise, by around 30% to 50% by the later stages, to supply the placenta and growing baby. For most healthy women, mild breathlessness, tiredness and a faster heartbeat are normal. Warning signs that need urgent medical attention include breathlessness at rest, chest pain, fainting, a persistent rapid heartbeat and sudden swelling, since these can occasionally point to conditions like preeclampsia or peripartum cardiomyopathy.
Pregnancy is full of joy and excitement, but it also brings changes you may not expect. As your baby grows, your heart pumps more blood and works harder to meet the needs of both you and your baby. For most healthy women, this is a normal part of pregnancy.
Still, a faster heartbeat, unusual tiredness or breathlessness can leave you wondering, “Is this normal?” Most of the time, these are normal pregnancy changes. Occasionally, though, pregnancy can reveal an underlying heart condition or make an existing one harder to manage. Knowing what to look out for can help you know when it is time to speak with your doctor.
One of the most important effects of pregnancy on the cardiovascular system is the increased amount of blood circulating through the body.
The placenta, uterus and growing baby all need a steady blood supply. To meet this demand, the cardiovascular system of a mother undergoes several adaptations:
Cardiac function can rise by around 30% to 50% during pregnancy, with changes beginning early and becoming more evident as pregnancy progresses. This increase results from a combination of a faster heart rate and a greater amount of blood being pumped with each heartbeat.
Your blood volume also increases during pregnancy. This helps deliver enough blood and oxygen to your baby while keeping your own organs well supplied.
An interesting point that is usually overlooked is that the heart’s workload does not simply return to its normal level immediately after childbirth. Labour and the period immediately after delivery involve further rapid changes in circulation. This is one reason women with significant heart disease may require careful monitoring around delivery and after birth.
A faster heartbeat can be one of the first things a pregnant woman notices.
As pregnancy progresses, the resting heart rate commonly increases because the heart needs to circulate more blood. You may also notice your heartbeat more clearly after going upstairs, walking fast or changing position.
Mild palpitations can occur during pregnancy and are not usually a sign of heart disease.
Still, if palpitations are persistent or severe, especially with dizziness, fainting, chest pain or significant breathlessness, talk to your doctor.
Some symptoms associated with increased cardiac function can overlap with ordinary pregnancy symptoms.
These may include:
However, you should pay attention to how severe, frequent or unusual your symptoms feel.
For example, feeling mildly breathless after climbing stairs can be normal during pregnancy. But feeling breathless while resting or suddenly struggling to lie flat is different and should be checked by a doctor.
This is especially important because some heart conditions, such as peripartum cardiomyopathy, can cause symptoms that may initially feel like normal pregnancy changes.
Pregnancy generally places a greater cardiovascular demand on the body, but most healthy hearts adapt successfully.
The stress on the heart during pregnancy may become more significant when a woman already has a cardiovascular condition, such as:
Pregnancy can sometimes reveal a previously unrecognised heart problem because the cardiovascular system is working more than usual.
Women with known heart disease should ideally discuss pregnancy with their cardiologist and obstetrician before conception. The level of risk varies considerably depending on the specific heart condition and how well the heart is functioning.
High blood pressure during pregnancy needs timely monitoring. Preeclampsia is a pregnancy complication that involves high blood pressure, usually after 20 weeks, along with signs that other organs may be affected.
It requires medical attention because it can affect both maternal and fetal health.
Preeclampsia and other hypertensive disorders of pregnancy should also be considered beyond childbirth. They are associated with an increased risk of cardiovascular disease later in life.
Peripartum cardiomyopathy is an uncommon form of heart failure. It develops towards the end of pregnancy or during the months following delivery. It can even affect women who have never previously been diagnosed with heart disease.
Its symptoms can resemble ordinary pregnancy or postpartum changes, including tiredness, breathlessness and swelling. New or worsening breathlessness, particularly at rest or when lying down, marked swelling, chest discomfort or a racing heartbeat should therefore not simply be attributed to pregnancy.
An echocardiogram or ultrasound scan of the heart, can help doctors evaluate how well the heart is pumping when this condition is suspected.
You should contact your doctor promptly if you experience:
If you have severe chest pain, trouble breathing or fainting, please seek urgent medical care. And after delivery, don’t simply brush off new or worsening symptoms as tiredness or sleepless nights. Your body is recovering, but some heart conditions can also develop during this time, so it is always better to get checked.
Taking care of your heart during pregnancy starts with regular antenatal care. Depending on your health and pregnancy, your doctor may recommend:
Exercise should always be individualised. Women with uncomplicated pregnancies are generally encouraged to remain physically active, whereas those with certain medical or pregnancy complications may need specific restrictions or guidance.
The connection between pregnancy and heart health does not end after your baby is born. Having conditions such as preeclampsia, high blood pressure or gestational diabetes during pregnancy can increase your risk of heart disease later in life.
These complications are a reason to pay a little more attention to your heart health after pregnancy. Keeping an eye on your blood pressure and blood sugar, eating well, staying active and maintaining a healthy weight can all help lower your future risk.
Women who maintain better cardiovascular health after pregnancy have a lower risk of developing heart disease later on.
If you already have a heart condition, have had heart surgery, or are experiencing symptoms such as frequent palpitations, fainting or ongoing breathlessness, it is a good idea to speak with a cardiologist.
If you have heart disease and are planning a pregnancy, consider getting checked before you conceive. Your cardiologist and obstetrician can review your heart health, medications and pregnancy plan, so you know what to expect during pregnancy, delivery and the postpartum period.
Pregnancy naturally makes your heart work a little harder. Your blood volume, heart rate and cardiac output increase to give you and your baby the blood and oxygen you need. For most healthy women, these changes are a normal part of pregnancy.
If you have an existing heart condition or notice symptoms that feel unusual or are getting worse, don’t ignore them. Conditions such as high blood pressure, preeclampsia and peripartum cardiomyopathy may need closer monitoring.
If you are pregnant, planning a pregnancy or simply worried about a new heart-related symptom, talking to a specialist can help you. The cardiology and obstetric department at the CK Birla Hospital work with a multi-disciplinary team-based approach to help you understand your heart health and plan the right care through pregnancy and after delivery.
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