Patients with attention deficit hyperactivity disorder (ADHD) should receive cardiac evaluation prior to treatment with stimulant medication, experts state.

The statement by the American Heart Association (AHA) follows warnings from the US Food and Drug Administration concerning the safety of stimulant medications in recent years.

Studies have raised concerns over the potential cardiovascular effects of psychotropic drugs, particularly tricyclic antidepressants, as well as stimulants.

ADHD stimulants have been associated with increased heart rate and blood pressure alongside the risk of sudden cardiac death (SCD).

The AHA's statement recommends adding an electrocardiogram to pre-treatment evaluations for children with ADHD.

"After ADHD is diagnosed, but before therapy with a stimulant or other medication is begun, we suggest that an ECG be added to the pre-treatment evaluation to increase the likelihood of identifying cardiac conditions that may place the child at risk for sudden death," Victoria Vetter, head of the statement writing committee, said.

"While we feel that an ECG is reasonable and helpful as a tool to identify children with cardiac conditions that can lead to SCD, if, in the view of their physician, a child requires immediate treatment with stimulant medications, this recommendation is not meant to keep them from getting that treatment," Ms Vetter added.

Future studies are necessary to assess the true risk of SCD in association with stimulant drugs in children and adolescents with and without heart disease, she concluded.

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