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Most of these changes are normal, however, some can indicate underlying issues or complications that require medical intervention. Understanding the difference between what is normal and what is not, is essential for both your and the baby’s development.
Normal Changes in the Heart During Pregnancy
The body needs a higher amount of blood supply during pregnancy. These changes are usually normal and temporary but can feel alarming if you are not aware of them. Here are some of the common changes.Increased blood volume and cardiac output:
- Your blood volume will increase by 30-50% by the end of your pregnancy to ensure enough oxygen and nutrients are delivered to your foetus.
- The volume of blood the heart pumps per minute, or the heart’s cardiac output, rises by about 30-40% as well.
- This higher workload causes the heart to work harder than usual, especially during the second and third trimester of pregnancy.
Heart size and chamber dilation:
- Fluid retention caused by pregnancy can lead to an increase in blood volume, which in turn can cause a slight enlargement of the heart.
- To handle this extra blood volume, the left ventricle, which is responsible for pumping blood to the body, undergoes mild dilation.
- The heart muscles thicken during pregnancy. This is called physiological hypertrophy and is usually reversible after childbirth.
Changes in blood pressure and heart rate:
- During pregnancy, blood pressure drops by a small margin, especially in the first two trimesters. This happens due to hormonal changes that relax blood vessels.
- Resting heart rate can increase by 20-30 beats per minute, which is normal.
- Usually, blood pressure returns to its normal, pre-pregnancy state after childbirth.
Valve and vascular changes:
- Pregnancy hormones can cause the blood vessels to soften and increase the ability of the heart muscles to stretch.
- Some women might experience mild heart valve regurgitation, which is a slight backflow of blood. This is usually harmless.
When Structural and Functional Changes in the Heart are Concerning
The heart is designed to adapt to the changes that occur during pregnancy. However, some women might experience abnormalities that require immediate medical attention.Hypertensive disorders and heart strain:
- Preeclampsia is a pregnancy condition characterised by high blood pressure and signs of organ damage. This condition increases stress on the heart.
- Chronic hypertension can cause the heart muscles to thicken and increase the risk of heart failure.
Peripartum cardiomyopathy:
- This condition is rare, but serious. It causes the heart to become enlarged and weakened, increasing the risk of heart failure.
- Symptoms may include fatigue, swelling and difficulty breathing. This usually occurs in the last month of pregnancy or during postpartum.
Arrhythmias and abnormal heart rhythms:
- While occasional palpitations may be common, persistent or severe arrhythmias may signal an underlying heart condition.
- Atrial fibrillation and other heart irregularities can increase the risk of clots and strokes.
Congenital or pre-existing heart conditions:
- Women who have congenital heart issues or any pre-existing conditions related to the heart may experience their symptoms worsening during pregnancy.
- In such cases, a pregnancy gets classified as a high-risk pregnancy and requires specialised medical care.
Warning Signs and When To Seek Medical Help
Heart issues require constant monitoring. It is important to keep a check on serious symptoms. Consult your doctor immediately if you experience any of the following:- Shortness of breath, especially while resting
- Severe chest pain or pressure
- Dizziness, fainting or confusion
- Swelling in the legs, especially if one leg is more swollen than the other
- Irregular, rapid or pounding heartbeats
- Severe headaches or vision changes (can be signs of high blood pressure related complications)
- Sudden weight gain or fluid retention (can be a sign of heart failure)
Managing Heart Health During Pregnancy
- Prenatal screening and monitoring: Even if you do not have pre-existing heart conditions, it is important for you to get a cardiac evaluation before getting pregnant or in early pregnancy. Additionally, regular prenatal check-ups monitor weight, blood pressure and heart function. For women who have pre-existing heart conditions, or high-risk pregnancies, regular echocardiograms and ECGs may be recommended for close monitoring.
- Lifestyle adjustments and preventative measures: Diet is one of the most important factors for cardiac health. Maintain a balanced diet with vegetables, lean proteins and whole grains. Limit your salt intake to ensure normal blood pressure, as a high-sodium diet can often lead to high blood pressure. Exercise is another very important factor. Regular, moderate exercise like walking, swimming or yoga can improve your cardiovascular health. Additionally, manage your stress by practising yoga, mindfulness and meditation. Stress is often associated with cardiovascular health issues.
- Medical intervention and treatment options: Medicines like anticoagulants and beta-blockers may be prescribed if needed. However, in severe cases, hospitalisation or early delivery might be recommended. For women with peripartum cardiomyopathy, regular postpartum checkups are crucial.
FAQs on Structural Changes in the Heart During Pregnancy: Normal vs Concerning
- Why does the heart change during pregnancy?The heart grows in volume during pregnancy to accommodate the increase in blood volume.
- When should I consult a doctor?Consult a doctor immediately if you have symptoms like shortness of breath, chest pain, excessive swelling in your legs or sudden weight gain due to fluid retention.