Pregnancy Complications: Heart Symptoms and Seeking Medical Advice

Pregnancy-related symptom consultation

Hello Doctor, I am a 30-week pregnant woman.
Before pregnancy, my health check showed slightly elevated TSH levels, but the endocrinologist said it was only a little high and that I didn't need to follow up.
Prior to pregnancy, I experienced occasional heart pain, about twice a year, which usually resolved in 2-3 minutes.
I also had gastroesophageal reflux issues before pregnancy, but as long as I avoided late-night snacks and didn't drink milk or soy milk at night, I was fine.
Recently, I have been experiencing the following symptoms and would appreciate your assistance.
Since the morning of May 29, I felt slightly unwell, unsure if it was due to lack of sleep or fatigue from late pregnancy.
On May 30, in the afternoon, I started to have a fever.
At 1:00 PM, my ear temperature reached around 38.5°C.
After resting, I began to sweat and the fever subsided by 5:30 PM.
However, at 6:30 PM, I felt cold, and my axillary temperature was 37.5°C.
I then went to a pediatrician for a cold, where I was informed that my only symptom was the fever.
Upon examination, the doctor found swelling in my nasal passages and prescribed paracetamol and cough expectorant.
After taking the medication at 8:00 PM, I sweated and felt better by 10:00 PM, so I went to sleep.
I woke up at 2:30 AM feeling cold and found my forehead temperature was 38.0°C.
The doctor advised that this medication should be taken every 6 hours, and taking too much could affect the baby, so I waited until 4:00 AM to take the medication.
This cycle of fever persisted until Sunday morning.
During the last two cycles, since my temperature was not high (forehead temperatures of 37.5°C and 37.6°C), I did not take any antipyretics, and my temperature decreased on its own.
However, I then developed ear pain, sore throat, swollen lymph nodes, white spots on the roof of my mouth, and symptoms of gastroesophageal reflux.
Knowing I had reflux issues, I only drank water and ended up sleeping in a sitting position for 3 hours before lying down, but I was still experiencing fever and discomfort.
Essentially, from Thursday to Sunday, I did not sleep well due to varying symptoms.
On Sunday morning, I went to see a doctor again.
After examining the roof of my mouth, the doctor found over ten white spots and diagnosed it as a viral infection.
However, he advised against antibiotics for pregnant women and prescribed paracetamol, cough expectorant, and medication for gastroesophageal reflux.
On Sunday, due to throat and ear pain, I only managed to eat one egg pancake throughout the day.
I experienced low-grade fevers but still felt fatigued.
While lying in bed before sleep, I suddenly felt my heart racing and slightly painful, with a heart rate of 120.
I thought a good sleep would help, but I was awakened three times by heart pain between 11:00 PM and 8:00 AM.
At 5:00 AM, I still had a fever, which had risen to over 38°C, unlike the previous low-grade fevers.
Consequently, I got up and took antipyretics.
When I woke up at 9:00 AM, my heart rate was still above 120, sometimes reaching 125.
As of now, at 2:00 PM, my heart rate is still around 120 with mild discomfort.
In the morning, I consulted with the pharmacy that dispensed my medication, and they said that the medications do not have side effects that would increase heart rate.
Additionally, besides the rapid heartbeat, I noticed that swallowing saliva or drinking water requires two swallows: the first passes through the throat, and the second goes down to the chest.
If I don't swallow a second time, I feel a sensation of something stuck in my chest.
I have numerous symptoms and am unsure which specialist to see.
Therefore, I am inquiring about what I feel might be the most serious issue, which is related to my heart.
I originally intended to consult my familiar obstetrician, but they are unavailable for a week.
Thank you, Doctor, for reading my message from this anxious pregnant woman.

Youyou, 20~29 year old female. Ask Date: 2024/06/03

Dr. Wu Xueming reply Cardiology

Due to the different endocrine status of pregnant women compared to the general population, it is recommended that you consult both a cardiologist and an endocrinologist to check for any abnormalities.

Reply Date: 2024/06/03

More Info

Pregnancy can bring about a myriad of physical changes and symptoms, some of which may cause concern, particularly regarding heart health. As a 30-week pregnant woman experiencing various symptoms, including heart palpitations, chest discomfort, and other systemic issues, it is essential to approach these concerns with a comprehensive understanding of both normal pregnancy physiology and potential complications.

Firstly, it is important to recognize that during pregnancy, the body undergoes significant cardiovascular changes. Blood volume increases, heart rate rises, and the heart works harder to supply oxygen and nutrients to both the mother and the developing fetus. This can lead to symptoms such as palpitations, which may feel like a racing heart or skipped beats. While occasional palpitations can be normal, especially in the context of pregnancy, persistent or severe symptoms warrant further evaluation.

Your history of occasional heart pain prior to pregnancy, along with the recent onset of symptoms such as fever, throat pain, and lymphadenopathy, suggests that there may be multiple factors at play. The fever and associated symptoms could indicate a viral infection, which is not uncommon during pregnancy and can lead to systemic symptoms, including increased heart rate and discomfort. The body’s response to infection often includes an elevated heart rate as part of the stress response, which can be exacerbated by dehydration or lack of sleep, both of which can occur during illness.

The sensation of needing to swallow twice could be related to esophageal reflux, which is common in pregnancy due to hormonal changes and pressure from the growing uterus. This can lead to discomfort that may be mistaken for cardiac symptoms. It is crucial to differentiate between gastrointestinal discomfort and true cardiac symptoms, as the management for each differs significantly.

Given your symptoms, it is advisable to consult both your obstetrician and a cardiologist. Your obstetrician can assess the overall health of your pregnancy and manage any obstetric concerns, while a cardiologist can evaluate your heart health more specifically. They may recommend tests such as an electrocardiogram (ECG) or echocardiogram to assess heart function and rule out any underlying cardiac issues.

In terms of managing your symptoms, maintaining hydration, ensuring adequate rest, and managing stress are essential. If you experience persistent high heart rates (tachycardia) or chest pain, it is critical to seek immediate medical attention. Additionally, if you are prescribed medications, such as those for fever or pain, ensure that they are safe for use during pregnancy.

Lastly, it is important to monitor your symptoms closely. If you notice any worsening of your condition, such as increased frequency of palpitations, persistent chest pain, or new symptoms like shortness of breath, do not hesitate to seek emergency care. Pregnancy is a time of significant change, and while many symptoms can be benign, it is always better to err on the side of caution when it comes to heart health.

In conclusion, while your symptoms may be related to normal physiological changes during pregnancy, they could also indicate a need for further evaluation. Collaborating with your healthcare providers will ensure that both you and your baby remain healthy throughout your pregnancy. Remember, your health and well-being are paramount, and seeking help is a vital step in ensuring a safe pregnancy journey.

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