Stimulant drugs, such as Ritalin, Adderall and Concerta, help children with ADHD stay focused and control their behavior. But these drugs can increase blood pressure and heart rate.

For most children, that isn't a problem. But for those with heart conditions, it could make them more vulnerable to sudden cardiac arrest - an erratic heartbeat that causes the heart to stop pumping blood through the body, and other heart problems.

The medications already carry warnings of possible heart risks in those with heart defects or other heart problems. These label warnings were added after a review by the Food and Drug Administration of its databases found reports of 19 sudden deaths in children treated with ADHD drugs, and 26 reports of other problems, including strokes and fast heart rates, between 1999 and 2003.

Now the Heart Association is recommending a thorough examination, including a family history, before children are put on the drugs, to make sure that they don't have any undiagnosed heart issues.

Dr. Victoria Vetter, a pediatric cardiologist at the University of Pennsylvania School of Medicine, and head of the committee making the recommendation, said a screening of about 1,100 healthy children found that about 2 percent of them had some kind of heart problem.

But Dr. Steven Pliszka, a child psychiatrist at the University of Texas in San Antonio, said he was baffled by the ECG recommendation. He said there was no evidence that sudden death was a bigger problem for children taking stimulants than for children who were not taking stimulants.

Pliszka feared an ECG could deter people from seeking treatment because it added expense and hassle. The American Academy of Child and Adolescent Psychiatry recently updated its treatment guidelines for ADHD, and did not recommend routine ECGs, Pliszka, who was the lead author, said. (Source: Hartford Courant)