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As
of April 23, 2008, the American Heart Association released a statement
recommending that children with attention deficit hyperactivity disorder (ADHD)
should have an electrocardiogram (EKG) - before starting treatment with
stimulant drugs. The AAP had previously maintained that such evaluation was not
necessary.
The
• Because certain heart conditions in children may be difficult (even, in
some cases, impossible) to detect, the AAP and AHA feel that it is prudent to
carefully assess children for heart conditions who need to receive treatment
with drugs for ADHD.
• Obtaining a patient and family health history and doing a physical exam
focused on cardiovascular disease risk factors are recommended by the AAP and
AHA for assessing patients before treatment with drugs for ADHD.
• Acquiring an ECG is reasonable for a physician to consider as part of
the evaluation of children being considered for stimulant drug therapy, but
this should be at the physician’s judgment, and it is not mandatory to
obtain one.
• Treatment of a patient with ADHD should not be withheld because an ECG
is not done. The child’s physician is the best person to make the
assessment about whether there is a need for an ECG.
• Medications that treat ADHD have not been shown to cause heart
conditions nor have they been demonstrated to cause sudden cardiac death.
However, some of these medications can increase or decrease heart rate and
blood pressure. While these side effects are not usually considered dangerous,
they should be monitored in children with heart conditions as the physician
feels necessary.
This clarification has been endorsed by the