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January 21, 2011

Children’s Hospital Responds to ADHD Meds and Heart Risk Alert

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The Pediatric Cardiology Division at the University of Virginia Children’s Hospital will begin offering electrocardiograms (ECG or EKG) for children on stimulant medications for Attention Deficit Hyperactivity Disorder. The move came after the American Heart Association recommended that children on stimulant medications – such as those used to treat Attention Deficit Hyperactivity Disorder (ADHD) – receive a thorough family history and cardiac exam by their medical care providers and an ECG read by a pediatric cardiologist to screen for significant heart disease. Experts at UVA Children’s Hospital say the recommendations are conservative but the information is worth knowing.

“Families should be reassured that there is no real urgency for a patient who is not having any difficulties,” said Dr. Paul Matherne, director of the Division of Pediatric Cardiology at UVA Children’s Hospital. “According to the guidelines parents should not stop their child’s medication and can have this screening done by their medical care provider at their next appointment. We are setting up a streamlined process to offer ECG screening to help medical care providers complete the screening process. If indicated we can also provide a detailed cardiac consultation.”

An ECG is a test that measures the electrical activity of the heartbeat. The ECG machine may look frightening to a child, but it is harmless.  Although its name has “electro” in it, it doesn’t send electricity into the body. Instead, it receives tiny electrical impulses that the beating heart makes and records them in a zigzag pattern on a moving strip of paper.

According to Dr. George McDaniel, director of the Pediatric Electrophysiology Program at UVA Children’s Hospital, this exam is important because not all children show obvious signs of a heart condition or abnormality.

“Some symptoms of underlying heart disease, such as dizziness or near fainting spells during intense activity, are often attributed to something else or dismissed as not being serious,” said McDaniel.

Stimulant medications like Ritalin or Concerta may carry a very small risk of cardiac problems for children with congenital heart conditions or abnormalities. Parents of children with known heart abnormalities, who are taking these types of medications, should talk to their cardiologist or local medical care provider.  For children who need an ECG as a part of the screening process, parents or medical care providers can schedule an appointment for an ECG by calling 434-924-2350. This will be available Monday through Thursday from 8 a.m. to 9 a.m. in the Pediatric Primary Care Clinic. The results will be sent to the patient’s medical care provider.

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