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Heart screening for kids with ADHD

March 8, 2010 12:00:00 AM PST
A new report in the Journal Circulation suggests widespread heart screening would save 13 young lives out of every 400,000 kids screened. But is it really worth the cost? Are these tests a reliable predictor? Researchers come down on both sides of the debate.Ritalin and stimulant drugs like it are some of the most widely prescribed drugs in the nation.

"It's estimated that five to seven percent, in the general public at least school age kids, are on ADHD medications," said Dr. David Ferry.

Dr. Ferry is a pediatric cardiologist at Northridge Hospital Medical Center. He treats many young heart patients who take drugs like Ritalin, Concerta and Adderall.

About 500 children die from sudden cardiac arrest each year. And about 10-percent of those happen to be on ADHD drugs.

Now a new report suggests if kids got an ECG screening before they started on these drugs, it would cut the risk of sudden death. But Dr. Ferry says it's not clear whether these medications are to blame.

"This is something that occurs in only five out of a million people. It's a very rare circumstance," said Dr. Ferry. "It's unclear really if the ADHD drugs do put most children at risk for anything happening."

There is no proof that these stimulant drugs cause sudden cardiac death, but the concern is that these medications can increase heart rate, blood pressure and potentially stress out the heart of someone with an underlying condition.

ECG testing would cost about $20 a child. But a child with an abnormality would undergo further testing, and in most cases it'll turn out to be nothing.

"It's unclear really if ECG screenings in large populations would really change the incidence of sudden death," said Dr. Ferry. "We really don't know what is best. We don't want to alarm the public. On the other hand we want to pick up those selectively who are at high risk."

Dr. Ferry says in Italy, widespread ECG screening of kids has reduced sudden cardiac death by 90-percent. But Italy has a national health system.

For now the American Academy of Pediatrics recommends kids prescribed ADHD drugs get a thorough clinical examination which includes: questions about family history of sudden cardiac death and whether kids faint or pass out during exercise.