To test or not to test?

Parents of kids with attention deficit hyperactivity disorder, or ADHD, want to know if their children should be screened for heart problems.

Rare deaths linked to treatment with stimulant medications have raised concerns. 

Jeremy Kuba has ADHD. After a year on medication to treat it, doctors found an electrical problem in his heart that needs monitoring. 
 
"When he first was diagnosed, they continued him on the medication. They kept telling me that they thought it was probably unrelated. But about a year later he kept progressing and getting worse and then they took him off and said he couldn't be on anything like that anymore," says his mother Roslyn Kuba.

It's a growing debate. Is the 11-year-old's heart problem a side effect of the ADHD drug or was the defect there all along? 

"I honestly don't know. And I feel I don't know because there was no heart test prior to putting him on the medication." 

Here's where the American Heart Association stands. In a recent statement, experts say ADHD may be more prevalent in kids with heart disease. For those with risk factors, it's reasonable to consider an electrocardiogram before prescribing ADHD drugs. 

"It's a reasonable test to get as per the guidelines, but it's not a required test. And in the absence of any problems on physical exam and in the absence of any family history, it's reasonable to not get an ECG," says Dr. Paul Matherne, a pediatric cardiologist at University of Virginia Health System in Charlottesville, VA.

As a pediatric cardiologist, Doctor Matherne sees a lot of these kids. He says the key is to weigh each child's heart health risk against the drug's benefit.
 
"And the risk of having a problem on these medicines, for most children, is vanishingly small."

Even so, some families feel it's better to be safe than sorry.

 
For the full statement from the American Heart Association log on to:
http://circ.ahajournals.org/cgi/content/short/117/18/2407

AUDIENCE INQUIRY:
If you have any concerns about medication use for your child, speak with your health care provider.
For general information about attention-deficit/hyperactivity disorder:
American Academy of Child and Adolescent Psychiatry, http://www.aacap.org
American Academy of Pediatrics, http://www.aap.org/publiced/BR_ADHD_FAQ.htm
Centers for Disease Control and Prevention, http://www.cdc.gov/ncbddd/adhd/default.htm
CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder, http://www.chadd.org
National Institute of Mental Health, http://www.nimh.nih.gov