How do you approach stimulant prescribing for ADHD when a patient has previously reported palpitations with stimulants but has a normal EKG off medication?  

Get a cardiology consult and get a certificate about stimulant safety before initiating stimulants.

Stimulant medications are unlikely to cause serious cardiac issues in pediatric patients without underlying heart disease; however, an EKG alone does not rule out all conditions that could contribute to a sudden cardiac event. Thus, if cardiac symptoms develop during stimulant treatment, referral to...

One time EKG is not enough to rule out a cardiac problem. If an EKG is done at the time of palpitations, it can yield more information. One needs a Holter monitor for 3 days to one week to rule out arrhythmia. And an echocardiogram to rule out the structural and functional status of the heart. All...