Heart palpitations are when the heart beats faster or more irregularly than usual. Though sometimes harmless in postpartum individuals, they can be a sign of a serious underlying condition.

Increased heart rate is typical during pregnancy, and it can take time for a person’s heart rate to return to its usual state. It is one of the numerous, relatively harmless causes of postpartum heart palpitations.

Thyroid problems, heart failure, and mental health conditions can also be causes. These serious conditions require immediate medical attention, so it is important to be aware of the warning signs.

In some cases, postpartum heart palpitations have nothing to do with a person’s pregnancy. The timing is merely coincidental. But in some cases, they are the result of hormonal changes after pregnancy. Only a thorough medical exam can determine the cause of heart palpitations.

Read more to learn about the different causes of postpartum heart palpitations and the warning signs of each cause.

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Cardiomyopathy is a disease of the heart muscle. It makes it difficult for the heart muscle to beat correctly, and in severe cases, it can lead to heart failure and death.

Being pregnant or having recently given birth are risk factors of cardiomyopathy.

In peripartum cardiomyopathy, the heart’s chambers get bigger. This makes the heart less efficient at pumping blood. As a result, the heart pumps less blood around the body, which can cause organ failure.

Symptoms

Peripartum refers to the period just before, during, and shortly after pregnancy.

The warning signs of peripartum cardiomyopathy can occur anytime during pregnancy. They can also be easy to miss. This is because many of the signs are similar to typical pregnancy symptoms, such as swelling and shortness of breath.

If a person has peripartum cardiomyopathy, they may notice other symptoms, such as:

  • palpitations
  • chest pain
  • dry cough
  • lightheadedness
  • fatigue (lack of energy)

Risk factors

Anyone can develop symptoms, but some factors increase a person’s risk. These include:

  • being of African descent
  • having pregnancy-related hypertension
  • having chronic high blood pressure
  • having multiple previous pregnancies
  • being pregnant with multiples
  • having overweight
  • having had peripartum cardiomyopathy before.

While those of African descent are at a higher risk, it is unclear if this results from genetics or racial health disparities. Numerous studies have documented the role of racism in worse maternal health outcomes for Black women.

Learn more about disparities in gynecological care.

Treatment

Treatment for peripartum cardiomyopathy focuses on helping prevent fluid accumulation in the lungs and helping the heart regain normal function. A person may need ongoing heart monitoring, and in some cases, to stay in the hospital.

A doctor may prescribe medications such as diuretics and beta-blockers. If a person is pregnant, a doctor may choose different treatment options and medication doses.

Prevention

It is not always possible to prevent peripartum cardiomyopathy. People can minimize their risk by maintaining good heart health. They can do this by regularly exercising, avoiding smoking and alcohol, and eating a balanced diet.

Individuals with the risk factors listed above should contact a doctor. Additionally, people who have had peripartum cardiomyopathy in the past are more likely to have it again.

Learn more about cardiomyopathy.

The thyroid is a butterfly-shaped organ in the neck. It produces hormones that help support pregnancy, regulate metabolism, control heart rate, and regulate body temperature.

Some people develop thyroid problems during or after pregnancy. Although many types of thyroid disease can cause heart palpitations, one potential condition is postpartum thyroiditis. It causes inflammation in the thyroid and usually appears in the first year after birth.

Symptoms

A person with postpartum thyroiditis may experience either high or low thyroid levels. This means they could experience either hyperthyroidism, which speeds up body functions, or hypothyroidism, which slows down body functions.

In most people, postpartum thyroiditis begins with symptoms of hyperthyroidism, including:

  • heart palpitations
  • unintentional weight loss
  • anxiety
  • difficulty tolerating heat
  • insomnia
  • sweating

Over time, this damages the thyroid, leading to hypothyroidism. This causes symptoms including:

  • low energy
  • difficulty tolerating the cold
  • depression
  • an enlarged thyroid
  • unintentional weight gain

Treatment

In the first stage of the disease, hyperthyroidism, treatment focuses on symptom management. For example, a doctor might prescribe beta-blockers to treat heart palpitations.

This stage is usually short, and not everyone needs treatment.

When the second stage, hypothyroidism, begins, doctors usually prescribe artificial hormones. These support thyroid function. A doctor will measure thyroid levels to assess whether ongoing treatment is necessary. Some people can stop treatment within 6–12 months.

Doctors do not know what causes postpartum thyroiditis, and there is no evidence that any specific intervention can prevent it.

Depression and anxiety may cause heart palpitations. They may also make existing palpitations worse.

It is possible to have depression or anxiety in addition to another condition causing heart palpitations, so it is important to rule out other causes.

Symptoms

Mood disorders during and after pregnancy, including postpartum depression and anxiety, are common.

Some symptoms of postpartum depression include:

  • feeling sad or hopeless
  • thoughts of suicide
  • thoughts of hurting the baby
  • difficulty bonding with the baby

Some symptoms of postpartum anxiety include:

  • feeling persistently anxious
  • unreasonable fears about the baby’s safety
  • obsessive or intrusive thoughts
  • developing compulsive behaviors
  • being unable to sleep or relax

Learn more about postpartum depression and postpartum anxiety.

Risk factors

As with most mental health conditions, postpartum depression and anxiety involve a person’s brain chemistry, hormones, genes, and environment.

A 2017 review identified several risk factors, including:

  • a previous history of mental illness
  • a history of sexual abuse
  • multiple prior pregnancies
  • having two or more children
  • a traumatic birth
  • getting pregnant before the age of 19 years
  • lack of social support
  • sleep deprivation
  • difficulty eating a nutritious diet
  • low physical activity

Treatment

Treatment usually involves a combination of medication (antidepressants or anti-anxiety drugs) and therapy.

A doctor will determine if a person needs medication, which one is right for them, and the appropriate dose. People who are breastfeeding should tell their doctor, as some treatments are not safe for breastfeeding.

Although postpartum mental health conditions are common, many people do not seek treatment. A 2011 study found that Black women are 57% less likely to receive treatment for postpartum depression than white women.

Learn more about postpartum mental health in women of color.

A person’s heart rate naturally increases during pregnancy, so a heartbeat that feels faster than usual does not always mean something serious is wrong.

But an arrhythmia, which is when the heart beats irregularly, may be cause for concern.

Atrial fibrillation, which causes the upper two chambers of the heart to beat irregularly, is a cause of heart rhythm issues during pregnancy. A heart rhythm monitor and a medical history, as well as bloodwork and imaging scans, may be able to help a doctor diagnose heart rhythm disorders.

Premature ventricular contractions (PVCs) can also occur during pregnancy. This is when the heartbeat comes early, causing the heart to contract earlier than expected. In most cases, they do not pose a risk to the fetus and will resolve themselves.

Other potential causes of irregular heartbeat include:

  • low blood sugar from diabetes medication or hunger
  • dehydration
  • nutrient imbalances or malnourishment
  • heart block
  • certain medications and drugs, especially stimulants such as caffeine
  • anemia

Because a person’s heart rate naturally increases during pregnancy, postpartum heart palpitations may be harmless.

But they may be the result of something more serious. These causes include peripartum cardiomyopathy, postpartum thyroiditis, and postpartum depression and anxiety.

These conditions are treatable, especially with early intervention.

People with symptoms of these conditions should seek medical attention in order to receive the appropriate care.