ABSTRACT
This chapter examines some of the issues regarding assessment and management of palpitations in pregnancy. Palpitation is an unpleasant awareness of an abnormal beating of the heart. The symptoms may be brought about by a number of cardiac disorders, including cardiomyopathy, valvular heart disease and coronary heart disease, or as a consequence of congenital heart disease, although most palpitations are benign. The investigation of palpitations in pregnancy is similar to non-pregnant patients, and includes baseline electrocardiograms, echocardiogram, and 24-hour Holter monitoring. The effect of pregnancy on the incidence of supraventricular tachycardia is unclear, but low oestrogen states may be arrythmogenic. Atrial fibrillation and flutter are rare in pregnancy and may indicate underlying structural heart disease, such as congenital heart disease or rheumatic valvular disease, or endocrine dysfunction. Congenital heart disease and repair of complex abnormalities has led to an increase in the number of female patients with congenital heart disease reaching childbearing age and having successful pregnancies.
