ECG Not Required for Kids With ADHD

July 30, 2008 -- Before a child goes on stimulant drugs to treat attention deficit hyperactivity disorder, they don't necessarily need to get an electrocardiogram (ECG) to screen for heart problems.

The American Academy of Pediatrics (AAP) and the American Heart Association (AHA) say it's "reasonable" for the child's doctor to consider ordering an ECG before prescribing stimulant drugs to treat ADHD, but those ECGs are "not mandatory."

That's a shift from the American Heart Association's earlier recommendation, posted online in April, that all kids or teens get an ECG before starting stimulant therapy for ADHD. At the time, the AAP's cardiology chair told WebMD that while ECG use was "reasonable" before starting kids or teens on stimulant drugs to treat ADHD, some false-positive results might come from routine ECGs for those patients, signaling heart risk where there is none.

Last December, researchers reported that while stimulants used to treat ADHD are known to raise blood pressure and heart rate, serious heart complications appear rare in kids who take the drugs.

In May, the AAP and AHA teamed up to clarify their stance, settling on the reasonable-but-not-mandatory approach to ECG use before prescribing ADHD stimulant drugs for kids or teens.

Children and teens should still get physical exams and be carefully screened for heart risks and family history of heart disease, but ECG doesn't have to be part of that, according to the AAP and AHA.

In its August edition of Pediatrics, the AAP encourages doctors to continue prescribing stimulant drugs to treat ADHD without obtaining routine ECGs or referring patients to pediatric cardiologists in most cases.