Connective Issues Winter 2026

What Should Families Do Before Starting ADHD Medication? Before starting medication, families should consult the child’s cardiologist. Baseline cardiovascular imaging—already routine for genetic aortic conditions—helps guide treatment decisions. In some cases, an electrocardiogram (ECG or EKG) may also be recommended. Heart rate and blood pressure should be checked before treatment begins, after any dose change, and regularly over time. Ongoing communication among providers is critical to ensuring safe and e ff ective care. What Warning Signs Should Prompt Medical Care? Serious cardiovascular events related to ADHD medications are rare, but families should seek medical attention if a child experiences: • Rapid, pounding, or irregular heartbeat • New or worsening shortness of breath • Severe dizziness • Sudden severe chest or back pain These symptoms may signal a serious heart or vascular issue and require immediate evaluation. What Monitoring Is Recommended During ADHD Treatment? Routine monitoring is a key part of safe treatment. If heart rate or blood pressure remains consistently elevated, medication adjustments may be needed, and the cardiologist should be involved. Growth should also be tracked. Stimulant medications can a ff ect appetite, weight gain, and, to a small degree, final adult height, particularly during the first two years of treatment. Are There Additional Red Flags for Children with Marfan Syndrome, Loeys-Dietz Syndrome, orVEDS? Children with Loeys-Dietz syndrome or VEDS face higher risks of arterial complications beyond the aorta. Strict blood pressure control, regular vascular imaging, and avoidance of certain medications like some decongestants or migraine treatments are especially important. All providers involved in a child’s care should be aware of the underlying diagnosis. Download the full resource. • Chest pain or tightness • Fainting or near-fainting

Key Takeaways forFa m ilies ✓ ADHD treatment can still be an option. Children with genetic aortic and vascular conditions can often be treated safely for ADHD when care is coordinated and closely monitored. Stimulants aren’t automatically ruled out. With cardiology approval and regular follow-up, stimulant medications may be used cautiously ande ff ectively. ✓ Team care matters. Your child’s pediatrician, cardiologist, and be havioral health provider should work together on treatment decisions. ✓ Monitoring is essential. Blood pressure, heart rate, growth, and symp toms should be checked routinely—especially when starting or adjusting medication. ✓ Know when to act. Seek medical care right away for chest pain, fainting, irregular heartbeat, severe dizziness, or sudden severe chest or back pain. ✓ Options extend beyond stimulants. Non-stimulant medications, behavioral thera py, school support, and healthy routines can all play a role. ✓ Needs change over time. ADHD and cardiovascular care should be re assessed as children move into adolescence and young adulthood. ✓ You can support both focus and safety. With informed decisions and ongoing care, families don’t have to choose between man aging ADHD and protecting heart health.

This article is intended for educational purposes only and should not replace individualized medical advice. Always consult your healthcare providers regarding diagnosis and treatment decisions.

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