Pregnant, Irregular heart rate, shortness of breath

[jguid95706]

I'm a 29 year old female, who is pregnant for the 6th time (2 children, 3 early miscarraiges).  I am currently 32 weeks pregnant, but I have been experiencing shortness of breath & heart palpitations for about 3 months now.

I first went to my OB somewhere around 20 weeks because I was having a hard time breathing while holding a conversation, walking or exercising.  I am/was in pretty good physical shape, I worked out 2-3 times a week, while working full-time, going to graduate school full-time, and handling my two other children.  Inactivity has never been my problem.   My heart rate was normal before the pregnancy, I used to check my pulse before, during and after exercise, and it’s never been erratic.  I’ve also never experienced shortness of breath without good cause.  I did have a heart murmur with my second pregnancy, but I was told that I do not have it this time.

The breathing thing was a bit scary, and I noticed that when I was feeling icky my pulse would be irregular, with a hard beat, a quick soft beat, a pause, and then repeat.  Sometimes for 15-20 minutes if I couldn't find a place to lay down (work).  It wasn't a fast beat, just odd.  During this time, I would feel like I was going to pass out, and I would get a cold sweat.  If I laid down, it would quickly go back to normal.

Finally, about a month ago I got very close to passing out, and my work called an ambulance to take me to the hospital.  Once I laid down, everything quieted down, and I felt fine.  They ran blood tests and an EKG, said everything looked fine, the only episode they caught was in the ambulance.  I was told to follow up with my doctor, and I was released.  By the time I walked out to the car, I was out of breath again, and feeling lightheaded.

I followed up with my doctor the next day, she sent me back to the hospital to be admitted for observation.  While I was there, I did very little, sitting around in the bed. I did try to walk around, but the ward was small and honestly, I was tired and stressed out.  I had a portable monitor on the whole time, nothing noted except frequent PAC's, some PVC's and a sudden rise in heart rate when I would first stand up (up to about 130bpm, my normal averages about 80).
I followed up with my Primary, she told me that my tests were basically normal, and that there was no reason behind the shortness of breath.  As a precaution, because I am pregnant, she told me to stop working and to stay home and rest as needed.

The tests were:
Echocardiogram:  trace mitral regurgitation & mild pulmonic valvular regurgitation.
Holter Monitor (24hr): avg hr 80bpm, range 56-144bpm. Periods of sinus arrhythmia.  Frequent PACs.  Atrial couplets noted.  A six-beat run of ectopic atrial tachycardia was recorded at a rate of 126 bpm. Ventricular couplets noted.  No higher grades of dysrhythmia.
Chest CT:  Suboptimal pulmonary artery opacification without evidence of gross central/segmental pulmonary embolism.
Chest X-ray: normal

My Obstetrician is concerned about my condition because my ability to tolerate normal activities seems to be gradually getting worse, although I am staying as physically active as I can.  My primary says that there is nothing wrong, and that I should get better after delivery.  This is problematic for several reasons.  One, the baby is breech, and the OB is concerned about the medication she has to give me to turn the baby because it is a heart stimulant.  Two, the OB is also concerned about me actually laboring, when I can barely tolerate a single flight of stairs.  Three, the OB also has concerns because the pain medications during birth have blood pressure and heart rate side effects.  Basically, I don’t know what to do, both my husband and labor coach both do not feel like my primary has any clue what is going on, and my OB is not satisfied with the nothing is wrong with me scenario either.
Should I request an appointment with a different doctor, or a cardiologist, or is this even a heart issue?  I understand that shortness of breath at the end of pregnancy is normal because of the pressure of the uterus, but this started so long ago that the baby was nowhere near my diaphragm.   I’m sure the worrying isn’t helping, I’ve noticed that when I am overheated or stressed out, my symptoms are much worse.  Should I just not worry about it?  If so, how do I reassure my OB that I will be okay in labor?

Thanks for any advice you can provide…

[AshAshNicole]

Hello, My name Ashley and I recently ran into your question ironically searching for answers myself about the shortness of breathe, light headedness, nausea and heart arrhythmia.
I know you wrote this article some years ago but I am having very similar issues and very early in my pregnancy I am six and half weeks. If you obtained any answers regarding these symptoms I would greatly appreciate being enlightened.

[marlinspike]

As I understand it pacs/pvcs are very common in pregnancy due to hormonal changes. TI get missed beats and find they can certainly be caused/made worse by stress and adreneline. It sounds like your echocardiogram and ekg were okay - but you are obviously worried about this so I would ask to see a cardiologist. Maybe you could you have a caesarian delivery. Pregnancy is very stressful and I think you need to put your concerns at rest about your heart. Best wishes.