ArticleJACC. Case reports2026
Shared Decision Making on Methylphenidate in Hypertrophic Cardiomyopathy and ADHD in a Young Athlete.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 authors.
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Abstract
backgroundExercise is not categorically contraindicated in hypertrophic cardiomyopathy (HCM), but concerns remain regarding sympathomimetic agents in patients with structural heart disease. CASE SUMMARY: A 26-year-old man with HCM, diagnosed at age 16, was referred for assessment of methylphenidate safety for attention-deficit/hyperactivity disorder (ADHD) and social anxiety treated with paroxetine. Cardiac imaging over 10 years showed stable septal hypertrophy with preserved systolic function and no high-risk features. Electrocardiogram showed left ventricular hypertrophy and repolarization abnormalities; QT dispersion was 74 ms, below high-risk thresholds in HCM cohorts. After counseling on arrhythmic risk and possible electrocardiogram surveillance, the patient declined methylphenidate and chose psychotherapy-based ADHD management while continuing exercise. DISCUSSION: This case shows how limited evidence on stimulant-related arrhythmic risk in low-risk HCM necessitates individualized assessment. TAKE-HOME MESSAGES: Shared decision making can align ADHD treatment with arrhythmic risk in HCM. Even when stimulants appear acceptable, patients may choose nonpharmacological ADHD strategies.
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