In This Article
Subscribe to Health Updates
Advanced Heart Screenings Recommended for ADHD Patients
May 17, 2008 9:33 PM
by
findingDulcinea Staff
The American Heart Association, concerned about the risk of sudden cardiac death, recommends electrocardiograms before prescribing ADHD medications.
Email This30-Second Summary
The American Heart Association wants doctors to give children electrocardiograms before prescribing drugs to treat attention deficit hyperactivity disorder. The association is concerned about detecting heart problems that could lead to sudden cardiac death. ADHD medications are stimulants that can raise a child’s blood pressure or heart rate. In a small group of children with heart problems, stimulants can raise the risk of SCD.
Nancy Shute at U.S. News and World Report says electrocardiograms may seem scary, but they are non-invasive, painless and inexpensive.
One psychiatrist says the American Heart Association’s recommendations are based on inconclusive data, and would add cost patients more money and lead to longer waits for treatment.
It is possible for children to have heart attacks, according to a case report published in the journal Pediatrics last year. That report found heart attacks in children who lacked traditional risk factors, such as a family history of heart problems, obesity and high blood pressure. That study did not mention Ritalin or other medications as a cause.
A teen’s death eight years ago led one doctor to worry about Ritalin and heart blockages, but he also said that the drug has been used for decades, and no such problem has been found.
Nancy Shute at U.S. News and World Report says electrocardiograms may seem scary, but they are non-invasive, painless and inexpensive.
One psychiatrist says the American Heart Association’s recommendations are based on inconclusive data, and would add cost patients more money and lead to longer waits for treatment.
It is possible for children to have heart attacks, according to a case report published in the journal Pediatrics last year. That report found heart attacks in children who lacked traditional risk factors, such as a family history of heart problems, obesity and high blood pressure. That study did not mention Ritalin or other medications as a cause.
A teen’s death eight years ago led one doctor to worry about Ritalin and heart blockages, but he also said that the drug has been used for decades, and no such problem has been found.
Headline Links: Heart screenings recommended during ADHD treatment
More than 2.5 million children take ADHD medication, according to The Philadelphia Inquirer. Last year, “a warning about possible risk to people with heart problems was added to the labels of most of these drugs after the Food and Drug Administration got reports that 19 children had died suddenly and an additional 26 suffered strokes, cardiac arrests, or other cardiovascular events while on the medication between 1999 and 2004.”
Source: The Philadelphia Inquirer
Though doctors examine children and note their family history, “some of the cardiac conditions associated with SCD may not be noticed in a routine physical exam. Many of these conditions are subtle and do not result in symptoms or have symptoms that are vague such as palpitations, fainting or chest pain,” according to a Heart Association statement.
Source: American Heart Association
Opinion: A necessary precaution?
“The idea of getting an ECG for a 10-year-old may sound freaky, but it’s a painless and inexpensive test that poses no risk to the child,” says Nancy Shute of U.S. News and World Report. Parents whose children are taking Ritalin or Adderall should call their pediatrician about screening.
Source: U.S. News and World Report
Dan Hartman, a doctor who writes the blog Sidewalk Psychiatrist, disagrees with the recommendations, which he says are based on old evidence that was reviewed and found “inconclusive, at best.” Hartman goes on to write, “The sad truth is that kids sometimes have cardiac events and the rate of those events is not statistically higher in kids that took stimulants."
Source: Sidewalk Psychiatrist
Related: Sudden cardiac problems in children
A 2007 study of nine teens and preteens who had heart attacks shows that the phenomenon is rare and under-diagnosed. Doctors at an Akron, Ohio, children’s hospital published the report. One doctor speculated the heart attacks were caused by a spasm that cut off the heart’s blood supply. The study did not implicate stimulants such as Ritalin.
Source: CBS News
The autopsy of a 14-year-old Michigan boy who had been taking Ritalin for 10 years when he suddenly died revealed blockages in his coronary arteries—a condition usually not found in someone that age. Dr. Lawrence Diller says that in 40 years of using Ritalin, “it stands to reason that if heart attacks were a common risk associated with these drugs, we should have discovered the link long ago.” But the case troubles him, and Diller suggests that any child complaining of chest pain or fatigue should be referred to a cardiologist.
Source: Salon
Reference: ADHD Web Guide
Read more about what ADHD is, how it is diagnosed and treated and where to find the latest news in the findingDulcinea ADHD Web Guide.
Source: findingDulcinea
© 2008 Dulcinea Media, Inc.
