Safety of stimulant medications for attention deficit hyperactivity disorder in paediatric congenital heart disease

Chung, Lorraine M; Hariharan, Gopakumar; Varma, Suraj

doi:10.1111/jpc.16380

Cited by 3 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our research methodology is intricately woven around the utilization of diverse datasets, each carefully chosen to address specific facets of our investigative objectives. The Heart Disease UCI dataset [21][22][23][24] serves as a foundational element, standing out with its comprehensive array of 76 attributes that encompass a wide range of patient-related information. From this dataset, we identified a subset of attributes crucial to our analysis.…”

Section: Datasetsmentioning

confidence: 99%

A Novel Machine Learning-Based Prediction Method for Early Detection and Diagnosis of Congenital Heart Disease Using ECG Signal Processing

Pachiyannan,

Alsulami,

Alsadie

et al. 2024

Technologies

View full text Add to dashboard Cite

Congenital heart disease (CHD) represents a multifaceted medical condition that requires early detection and diagnosis for effective management, given its diverse presentations and subtle symptoms that manifest from birth. This research article introduces a groundbreaking healthcare application, the Machine Learning-based Congenital Heart Disease Prediction Method (ML-CHDPM), tailored to address these challenges and expedite the timely identification and classification of CHD in pregnant women. The ML-CHDPM model leverages state-of-the-art machine learning techniques to categorize CHD cases, taking into account pertinent clinical and demographic factors. Trained on a comprehensive dataset, the model captures intricate patterns and relationships, resulting in precise predictions and classifications. The evaluation of the model’s performance encompasses sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve. Remarkably, the findings underscore the ML-CHDPM’s superiority across six pivotal metrics: accuracy, precision, recall, specificity, false positive rate (FPR), and false negative rate (FNR). The method achieves an average accuracy rate of 94.28%, precision of 87.54%, recall rate of 96.25%, specificity rate of 91.74%, FPR of 8.26%, and FNR of 3.75%. These outcomes distinctly demonstrate the ML-CHDPM’s effectiveness in reliably predicting and classifying CHD cases. This research marks a significant stride toward early detection and diagnosis, harnessing advanced machine learning techniques within the realm of ECG signal processing, specifically tailored to pregnant women.

show abstract

Section: Datasetsmentioning

confidence: 99%

A Novel Machine Learning-Based Prediction Method for Early Detection and Diagnosis of Congenital Heart Disease Using ECG Signal Processing

Pachiyannan,

Alsulami,

Alsadie

et al. 2024

Technologies

View full text Add to dashboard Cite

show abstract

“…11,12 Multiple studies have shown that children with complex medical conditions including congenital heart disease can be safely and effectively treated with stimulant medication. Second, while ADHD medications are highly effective and well tolerated for the majority of patients, including those with congenital heart disease, 13 side effects can outweigh benefit at times and may lead to treatment discontinuation. As this case highlights, it is not known whether susceptibility reflects a specific underlying condition and/or hemodynamic changes induced by a given medication; with a limited formulary clinicians and families will need to carefully weigh the risks and benefits of ADHD medication use for each individual child.…”

Section: Sarah Plummer MDmentioning

confidence: 99%

Complex ADHD Challenging Case: Managing Co-Occurring Attention-Deficit Hyperactivity Disorder and Congenital Heart Disease with a Limited Medication Formulary: A Case from Mexico

Medina,

Hammerness,

Ihyembe

et al. 2024

J Dev Behav Pediatr

View full text Add to dashboard Cite

CASE: DL is an 8-year-old Mexican boy with a posterior atrial septal defect and partial anomalous pulmonary venous return of the right lower pulmonary vein with resultant right heart dilation with normal right ventricular systolic and diastolic function and no arrhythmias. Surgical repair was deferred, and DL's condition was being medically managed with furosemide 0.5 mg/kg BID and spironolactone 0.5 mg/kg BID. DL presents for developmental assessment due to poor performance in school following a lifting of COVID-19 pandemic restrictions and return to in-person classes. He has been attending full-time classes for 3 months without improvements in math, reading, and writing skills. Current attentional concerns at school include an inability to complete tasks without getting distracted by minimal stimuli and highly impulsive behavior. At the first assessment, DL was performing below grade expectations (e.g., reading by syllable without text comprehension, demonstrating preoperational addition and subtraction skills, inability to take dictation)—all of which was viewed as negatively impacted by attentional deficits. DL met DSM-5 criteria for ADHD, predominantly inattentive type. He was started on 10-mg immediate-release methylphenidate PO at 8 am with breakfast and a second dose of 10-mg immediate-release methylphenidate PO 4 hours after the first dose. After a month, at the first follow-up consultation, improvement in attention span, impulsivity, and school performance were observed, including reading skills and math proficiency. However, DL's mother raised concerns about circumoral cyanosis and acrocyanosis in the fingers of both hands after playing outside. These signs were not previously observed. During physical examination at the same visit, heart rate, blood pressure, and oximetry were within baseline ranges and his cardiac examination was unchanged. DL's dosage of methylphenidate was lowered to 10-mg immediate-release methylphenidate PO QD in the mornings with breakfast (8 am). DL did not return to clinic for another 2 months, having discontinued the medication after 2 months of treatment given financial limitations. His mother reported that DL's exertional circumoral cyanosis and acrocyanosis resolved while he was off medication. However, she observed an increase in inattentive symptoms and impulsivity and decline in his academic skills. She asked if our team was able continue the treatment despite the drug side effects, since she believed the benefits outweighed the disadvantages. Given these concerns, the team requested an updated cardiology assessment. The Cardiologist recommended discontinuation of methylphenidate and recommended follow-up with cardiothoracic surgery for reassessment of the surgical timeline. Given the limited treatment options in Mexico, what would you do next as the treating developmental-behavioral clinician…?

show abstract

“…The current study could not explore the risk in this clinical popu-lation. A recent review 9 concluded that stimulants can be safely started in mild congenital cardiac conditions (ventricular septal defect, atrial septal defect, and isolated semilunar valve disease). By contrast, with complex congenital heart disease cases, cardiology opinion is recommended before initiating stimulants.…”

mentioning

confidence: 99%

Long-Term Cardiovascular Effects of Medications for Attention-Deficit/Hyperactivity Disorder—Balancing Benefits and Risks of Treatment

Cortese,

Fava

2024

JAMA Psychiatry

View full text Add to dashboard Cite

Safety of stimulant medications for attention deficit hyperactivity disorder in paediatric congenital heart disease

Cited by 3 publications

References 19 publications

A Novel Machine Learning-Based Prediction Method for Early Detection and Diagnosis of Congenital Heart Disease Using ECG Signal Processing

A Novel Machine Learning-Based Prediction Method for Early Detection and Diagnosis of Congenital Heart Disease Using ECG Signal Processing

Complex ADHD Challenging Case: Managing Co-Occurring Attention-Deficit Hyperactivity Disorder and Congenital Heart Disease with a Limited Medication Formulary: A Case from Mexico

Long-Term Cardiovascular Effects of Medications for Attention-Deficit/Hyperactivity Disorder—Balancing Benefits and Risks of Treatment

Contact Info

Product

Resources

About