Tuesday, April 29, 2008

New Guidelines Urge Heart Tests Before Taking ADHD Drugs

Excerpts from article by RON WINSLOW
Wall Street Journal
April 22, 2008; Page D1

Children diagnosed with attention deficit and hyperactivity disorder should have a thorough heart work-up, including an electrocardiogram, before taking stimulants such as Ritalin to treat the condition, according to a new recommendation by the American Heart Association.

The advice marks the first time a medical-guidelines body in the U.S. has urged wide use of an electrocardiogram, which charts electrical activity in the heart, to screen a presumed healthy population for abnormalities.

But there is debate among experts about the value of using the test to screen such a large pool of patients to detect a rare condition. The hope is that such a test -- in combination with a comprehensive checkup -- will help to avoid the rare cases of sudden cardiac arrest that have been linked to the widely used medicines.

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A child diagnosed with ADHD should get a thorough heart checkup, including:
Patient and family history, with special attention to palpitations, fainting or recent difficulties during exercise.
A physical, including blood pressure and a check for abnormal heartbeats.
An electrocardiogram to measure electrical function of the heart.
If necessary, a consultation with a pediatric cardiologist to discuss important findings.
Source: American Heart Association

"The goal is to improve the care of children, including allowing them to have their ADHD treated and have it done safely," says Victoria Vetter, director of electrophysiology at Children's Hospital of Philadelphia and lead author of the heart association's statement.


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