Medical News Today: Chest pains during pregnancy: What to know

Many women experience pain or discomfort during pregnancy, and some of these sensations can mirror symptoms of cardiac conditions. These issues include:

These can be worrying, but often, they do not result from a serious health problem.

Some relatively harmless issues that can cause chest pain during pregnancy are outlined below.

Heartburn

When a person eats, a valve between the esophagus and stomach opens to let food into the stomach. This valve is called the esophageal sphincter.

When a person is not eating, the esophageal sphincter ordinarily closes to stop partially digested food and stomach acid from rising back up into the esophagus. If this does occur, the issue is called acid reflux.

During pregnancy, rising levels of the hormone progesterone cause the esophageal sphincter to relax, increasing the risk of acid reflux.

Acid reflux can cause heartburn, a burning sensation in the throat or mouth that is common after eating, particularly when the person is lying down after a meal.

The following strategies can help prevent heartburn:

• avoiding spicy or greasy foods
• eating smaller meals
• remaining upright for longer after eating

A doctor or pharmacist may recommend taking an antacid for persistent heartburn during pregnancy. This type of medication neutralizes stomach acid, relieving the pain.

Growing uterus and fetus

As the fetus and uterus grow, this increases pressure on surrounding organs, including the lungs and stomach.

This pressure can cause discomfort and pain in the chest, typically during the second and third trimesters. Increasing pressure in the chest cavity can also cause:

• a woman to feel full more quickly while eating
• a faster heartbeat
• acid reflux
• shortness of breath

A pregnant woman who experiences the symptoms above should see a doctor to make sure of the cause.

The cause of chest pain during pregnancy may be a severe health issue, such as preeclampsia, a heart attack, or another heart condition.

Preeclampsia

Chest and shoulder pain during pregnancy can indicate a serious complication called preeclampsia. This can sometimes be fatal for the mother and fetus.

Common signs and symptoms of preeclampsia include:

Preeclampsia typically goes away once the baby is born. However, in some women, preeclampsia continues after pregnancy or begins after they have given birth.

Women with preeclampsia may also experience related complications, such as eclampsia or a syndrome that involves rupturing of red blood cells, a low platelet count, and elevated liver enzymes — commonly called HELLP syndrome.

A woman may not know that she has preeclampsia or related complications. Regular health checks and tests help doctors identify these issues.

Heart disease or heart attack

A relatively uncommon cause of chest pain during pregnancy is a heart attack.

During pregnancy the volume of blood in the body increases to accommodate the growing fetus. In order to pump the extra blood efficiently, the woman’s heart rate increases, and this added strain leads to a higher risk of a heart attack.

A 2018 study investigated the incidence of heart attacks among women in the United States who stayed in the hospital for complications of pregnancy or the adjustment period afterward. Heart attacks had occurred in 8.1 out of every 100,000 of these women.

Women who have heart disease or other preexisting cardiac conditions have an increased risk of a heart attack during pregnancy.

The following symptoms can indicate heart disease:

• chest pain
• a fast heartbeat
• a chronic cough
• extreme breathing difficulties
• extreme fatigue
• extreme swelling or weight gain
• fainting

A pregnant woman who experiences any of the above symptoms should see a doctor immediately.

In many cases, chest pain and discomfort result from relatively harmless issues. However, a woman should see a doctor if she has any concerns about her health or that of the fetus.

It is important to attend every appointment with a doctor or midwife and to undergo every recommended test. These can indicate whether any complications have developed and ensure that the mother and baby are healthy.

Women who experience any symptoms of heart disease or preeclampsia during or after pregnancy should receive immediate medical care.

It is also crucial that pregnant women are aware of the symptoms of a heart attack. According to the American Heart Association (AHA), these include:

• chest pain or discomfort
• pain, pressure, or a squeezing sensation in the center of the chest that lasts for more than a few minutes or goes away and comes back
• shortness of breath, which may be accompanied by chest discomfort
• cold sweats
• lightheadedness
• nausea
• discomfort or pain in the jaw, neck, stomach, back, or in one or both arms

A pregnant woman who experiences any of these symptoms and believes that the cause may be a heart attack should call 911 immediately or otherwise seek urgent medical assistance.

Chest pain can be a harmless symptom of pregnancy. The cause is often heartburn or pressure as the growing uterus pushes against the organs in the chest cavity.

However, chest pain during pregnancy can indicate a more serious condition, such as a heart attack or preeclampsia. These require immediate medical attention.

Pregnancy can be a physically challenging time. Anyone with any concerns about their health or that of the baby should consult a doctor.