Is this normal?

Hi, about a year ago, I was diagnosed with SVT and was put on 120 mg of Verapamil three times a day.  At first it seemed to work very well at controlling my SVT symptoms, but I have noticed recently that I have had episodes of fatigue, coughing, chest pain, weakness, rapid heart rate with mild exercise.  If I take my dog for a short run, my heart rate goes up so much, I become extremely short of breath and my chest starts hurting.  It takes at least five minutes for my heart rate to come back down.  When I walk on the tread mill, the heart monitor says that my heart rate is fluctuating between 54 bpm-145 bpm and I am having chest discomfort. Then all of a sudden my heart rate will stabilize after 15 minutes of walking and then the chest discomfort will go away.
One night I got up quickly and walked into another room and I felt very weak, my heart was racing and I almost passed out.  I had to sit down in a chair and bear down to slow down my heart rate.  
Another time my husband and I were grocery shopping and I started feeling weak and shaky.  I thought I was just hungry so I ate a snack.  In the parking lot, I started having chest pressure and started coughing and having palpitations. Then I just fell face first in the parking lot.  Then it passed within a few minutes.

I was wondering, is this par for the course of having SVT? Or is this a warning that my medications are not working anymore?  Does this sound like SVT symptoms, or something else entirely?I heard about ablation, but I don't know at what point this procedure is recommended.

Also, does anyone else have SVT and migraines?

Thanks.

[cindy707]

I used to have SVT among other things but got it taken care of with a regular ablation four years ago and now no SVT and yes i went thru alot of the same that you are.  It may just be that you have built up a tolerance to the meds over time and the doc simply needs to change you out but no matter what you do .....do not stop taking the pills suddenly it can be very bad for you and you need to do that under the supervision of the doctor.  I think that when the coughing is happening your body is just attempting to reset the electrical of your heart thats pretty normal but passing out is not and when that happened you should have immediately called 911...this is all probably intertwined together and your heart docs needs to do a full work up on you and hopefully they will put you on a Holter Monitor for at least a week to try to put a finger on what the next stage of the game will be.  Sounds like you need a treatment plan and hopefully you are seeing a good heart doctor.....

[is_something_wrong]

Hi,

No, this is not normal and you need to get your heart rhythm monitored while exercising, you can ask for a Holter Monitor or a stress EKG test.

As Cindy said (good advice by the way), see a good heart doctor (cardiologist) and discuss this with him. I have a slight suspicion that you are in another rhythm when exercising (such as atrial fibrillation), and you need to get this ruled out or confirmed.

Verapamil 120 mg x 3 is pretty aggressive treatment for SVT I think, and may have side effects (do NOT change without asking your doctor!!). If you're only 39 years old, you could ask your doctor for an EP study and ablation, to permanently cure the SVT and get this problem solved once and for all.

[tom_h]

The way you describe your symptoms, it sounds like your heart rate varies in speed.  Think of SVT as mashing the gas pedal of your car to the floor.  There's no in between with SVT, it's normal one second, pedal to the metal the next.  There are quite a few different drugs to treat SVT symptoms.  You and your physician should explore other possibilities or dosages.  I've been taking Metoprolol for quite a few years to control my SVT.  This is a relativel common class II anti-arrhythmic.  At one point I was on 4X the dosage I'm currently on.  I felt like a zombie, my BP was rediculously low, and I had that cinder block on the chest feeling every time I tried to do anyu kind of physical exertion.  Whith a little adjustment, I settled on a dose that worked sufficiently (although there were breakthroughs) but had minimal side effects.  As was mentioned above, although Verapamil is indicated for the treatment of SVT, it is a very powerful drug.  I request a couple of things.
1) a basic stress test or....
2) an echo stress test
3) a long term monitor.  Quite often, a 24 hour Holter isn't on long enough to to catch any events.  A 30 day monitor is like a deck of cards an involves the daily placement of 2 sticky pads on either side of your chest.  It's very easy, and the data it collects although basic (only 1 angle) is valuable in telling just exactly what's going on with your heart.

So, are you really having episodes of SVT?  The way you describe it, perhaps not.  But a monitor will really help in determining that.