Echocardiogram Before Concerta

Our pediatrician has suggested Concerta for our child with ADHD. We have tried everything other than meds and we are ready to make this move. There have been very rare cases of sudden death due to arrythmia and cardiomyopathy. These seemed to be in kids with existing heart problems. The Pediatrician will do a baseline exam and take a family hx and see her monthly to monitor to make sure there are no problems. I suggested an echocardiogram to ensure that there are no structural abnormalities of the heart and her response was that this was not necessary nor is it recomended by the ACP.  Does that make sense? it seems like she would want to do everthing she can to be sure there are no pre-existing heart problems and I would think that what you can find on echo is different from what you're going to find on physical examination.