Website maintenance is planned from 8:00 a.m. CDT Saturday, July 27, through 9:00 p.m. CDT Sunday, July 28. Brief disruptions may occur during this time.
Many pediatricians obtain ECGs in healthy patients with no personal or family history* of cardiac disease prior to initiating stimulant therapy for attention-deficit/hyperactivity disorder out of fear of triggering an adverse cardiovascular event or worsening a previously undiagnosed cardiovascular disease. However, the probability that such screening will lead to the diagnosis of cardiac disease is low. Furthermore, when ECG abnormalities are identified, they rarely warrant a change in planned attention-deficit/hyperactivity disorder therapy. As a result, obtaining the ECG increases health care costs and can increase stress for both the patient and family. If there is concern based on the history and physical examination, then a pediatric cardiology referral is a reasonable consideration. (*Family history should assess specifically for the following types of cardiovascular diseases: connective tissue disorders; cardiomyopathies; arrhythmias, including need for pacemaker or defibrillator implantation; storage diseases; sudden unexplained death; premature cardiovascular disease prior to the age of 50 years.)