PITTSBURGH (KDKA) — Should children get a heart screening before starting stimulant drugs for attention deficit hyperactivity disorder?

One in four pediatricians thinks so in the first study asking doctors specifically about this topic.

“Pediatricians in the community feel like they’re not getting enough advice in this regard,” says Dr. Vivek Allada, a pediatric cardiologist at Children’s Hospital Pittsburgh.

The concern is sudden cardiac death. This has occurred in kids with ADHD taking stimulants — drugs like Ritalin, Adderal, and Concerta.

“There were 20 such reports, 20 such cases over a very long period of time, and it involved millions of doses of medications,” Dr Allada points out.

Published in the journal Pediatrics, the government sponsored survey of more than 500 pediatricians shows that they more often discuss weight loss, loss of appetite, sleep disturbance and moodiness. Less than half talked about cardiac risks.

The American Heart Association and the American Academy of Pediatrics have gone back and forth about whether an EKG — or a heart rhythm test — is needed before starting these medications. Most doctors in the survey are not getting this test, but they are getting a detailed cardiac history from the patient and family.

Dr. Allada believes this is enough. He says the EKG is not perfect and the numbers are so low, the benefit is low, too.

“It’s still a good history and physical that gets the best evaluation, and decision about doing an EKG is the next step,” he says. “It doesn’t pick up all the conditions that can lead to sudden cardiac death.”

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Dr. Maria Simbra