Dyspnea and Palpitation during Pregnancy

Abstract

ObjectivesDyspnea and palpitation are common features of pregnancy. While several theories have been put forward to explain the etiology of gestational dyspnea and palpitation, there have been few systemic studies of its incidence, severity and time-course in a group of normal women.MethodsWe interviewed postpartum women, within 3 days after delivery, about dyspnea and palpitation. Separately from this interview, we performed 24-hour ECG monitoring for obstetric patients with palpitation before delivery.ResultsThe subjects interviewed were 261 women, of whom 37.5 percent and 11.5 percent experienced dyspnea and palpitation, respectively. These symptoms had a tendency to increase to term. The presence of arrhythmias could be documented in only 22% of patients having 24-hour Holter monitoring.ConclusionDyspnea and palpitation were common among normal pregnant women and had a tendency to increase to term.

Pulmonary embolism during and after pregnancy

“…However, the classic symptoms of VTE are less specific during pregnancy. Leg swelling (17) and pain (17), dyspnea (9,10,17,18), tachypnea (10,17), tachycardia (9), and palpitations (9) are symptoms common among normal pregnant women and tend to increase toward the end of gestation. Therefore, the diagnosis can be confirmed only by objective testing.…”

“…However, many of the classic symptoms of venous thromboembolic disease, including tachycardia, tachypnea, dyspnea, and leg swelling, may also be associated with a normal pregnancy (9,10). Refuerzo et al (3) performed a retrospective review of the clinical signs and symptoms in patients who, during pregnancy or within 6 wks postpartum, were suspected to have a pulmonary embolism (PE).…”

Gestational Outcomes of Beta Blocker Therapy as a Treatment of Palpitations

“…Although a common reason for referral, the true incidence of palpitations during pregnancy remains unknown. One study by Author et al, in which an interview of postpartum women was conducted within 3 days after delivery, 11.5% experienced palpitations during their pregnancy [1]. In our study, 228 out of 3778 (6%) women had heart palpitations during their pregnancy.…”

“…Heart palpitations are one of the most common reasons for referral to the internist and cardiologist, both in the general population and during pregnancy [1]. Although beta blocker (b-Blocker) therapy (BBT) can alleviate palpitations; in the absence of hemodynamically significant arrhythmia, medical treatment for the symptomatic relief of palpitations is not generally recommended [2].…”

Prenatal and cardiovascular outcome in pregnant patients with dyspnea

“…The exact mechanism of dyspnea during pregnancy is not yet known; however, it may be due to increased metabolic needs or mechanical causes during pregnancy (8). In pathologic situations, 85% of patients with dyspnea are related to one of the following etiologies: asthma, pneumonia, cardiac ischemia, pulmonary disease, heart failure, obstructive airway disease and psychological problems (9,10). Regarding the great importance of cardiac diseases and their related morbidity and mortality, mainly during pregnancy and due to unknown nature of many such diseases, the European Cardiac Society Guideline on cardiac disease in pregnancy recommended precise evaluation in pregnant women with dyspnea or an induced dyspnea following pregnancy (2).…”