Unusual Presentation of Postprandial Sinus Tachycardia in Pregnancy

This report describes the clinical presentation and systematic workup of a 25-year-old primigravid woman presenting at 34 weeks gestation with symptoms of postprandial sinus tachycardia. Differentials included pregnancy-related inappropriate sinus tachycardia (PRIST) and swallowing-induced atrial tachycardia. PRIST has favorable outcomes for both the mother and baby, although the symptoms can be distressing and lead to the overutilization of healthcare resources. The literature describes symptom onset as sporadic with no definitive triggers, often occurring in the later trimesters of pregnancy. Swallowing-induced atrial tachycardia, which fits with postprandial symptoms seen in this patient, is a distinct entity most commonly diagnosed in middle-aged men. Management included psychosocial support and pharmacologic treatment with labetalol. The patient’s course was benign with an uncomplicated delivery at 38 weeks, complete resolution of symptoms in the postpartum period, and successful discontinuation of pharmacologic management with no relapses. Current literature on postprandial sinus tachycardia in pregnant women is limited, and the best treatment method is unknown. This report extends current knowledge on pregnancy-related postprandial sinus tachycardia and provides a framework for advances in the management of this clinical presentation.