What could cause sudden palpitations twice during the second trimester of pregnancy, and what should be done?

Occasional palpitations during the second trimester of pregnancy may be caused by increased blood volume, emotional fluctuations, anemia, gestational hypertension, or arrhythmia. These symptoms can be improved by adjusting lifestyle, enhancing nutrition, or using medications. If palpitations occur frequently or are accompanied by chest tightness and shortness of breath, prompt medical attention is necessary.

1. Increased Blood Volume: During pregnancy, blood volume increases, placing greater strain on the heart, which may lead to occasional palpitations—often more noticeable after physical activity. It is recommended to avoid strenuous exercise, perform daily activities slowly, and avoid prolonged standing to reduce cardiac load.

2. Emotional Fluctuations: Hormonal changes or psychological stress during pregnancy can cause anxiety and tension, leading to sympathetic nervous system activation and palpitations. Listening to soothing music and communicating with family members can help regulate emotions and maintain mental calmness.

3. Anemia: Increased iron requirements during pregnancy, if not adequately met, can lead to anemia. This reduces the blood's oxygen-carrying capacity, causing the heart to beat faster to compensate, resulting in palpitations along with dizziness and fatigue. Symptoms can be improved under medical guidance using medications such as ferrous succinate tablets, vitamin C tablets, or polysaccharide-iron complex capsules.

4. Gestational Hypertension: Elevated blood pressure during pregnancy increases peripheral vascular resistance and cardiac workload, leading to palpitations, often accompanied by abnormal blood pressure readings and lower limb edema. Under medical supervision, medications such as labetalol tablets, nifedipine sustained-release tablets, or methyldopa tablets may be used to manage symptoms.

5. Arrhythmia: Structural or electrophysiological changes in the heart during pregnancy may lead to occasional arrhythmias, manifesting as sudden, brief episodes of palpitations. Symptoms should be managed under medical guidance with medications such as metoprolol sustained-release tablets, propafenone tablets, or adenosine injection.

Daily care should include ensuring adequate sleep and avoiding excessive fatigue, maintaining a balanced diet rich in iron and protein, engaging in light walking, staying emotionally positive, and closely monitoring palpitations and other bodily changes.