{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:19:11Z","timestamp":1777724351139,"version":"3.51.4"},"reference-count":78,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>Cardiac disease in pregnancy is an important cause of maternal morbidity and mortality. In many high-income countries, acquired cardiac disease is now the largest cause of maternal mortality. Given its prevalence in low- and middle-income countries (LMICs), rheumatic heart disease is the most common cause of cardiac disease in pregnancy worldwide and is associated with poor maternal outcome. The diagnosis of cardiac disease in pregnancy is often delayed resulting in excess maternal morbidity and mortality. Maternal mortality review committees have suggested that prompt recognition and treatment of heart disease in pregnancy may improve maternal outcome. Given the similarities between symptoms of normal pregnancy and those of cardiac disease, the clinical diagnosis of heart disease in pregnancy is challenging with echocardiography being the primary diagnostic modality. Focused cardiac ultrasound (FOCUS) at the point of care provides supplemental data to the history and physical examination and has been demonstrated to permit early diagnosis and improvement in the management of cardiac disease in emergency medicine, intensive care, and anesthesia. It has also been demonstrated to be useful in surveillance for rheumatic heart disease in LMICs. The use of FOCUS may allow earlier and more accurate diagnosis of cardiac disease in pregnancy with the potential to decrease morbidity and mortality in both developed and developing countries.<\/jats:p>","DOI":"10.1177\/10815589221142195","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T02:08:42Z","timestamp":1674526122000},"page":"81-91","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Focused cardiac ultrasound in pregnancy"],"prefix":"10.1177","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3452-8968","authenticated-orcid":false,"given":"Paul","family":"Edwards","sequence":"first","affiliation":[{"name":"Heart Institute of the Caribbean, Kingston, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinyere","family":"Anyaogu","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, Bronx, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7454-7410","authenticated-orcid":false,"given":"Kenechukwu","family":"Mezue","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dainia","family":"Baugh","sequence":"additional","affiliation":[{"name":"Heart Institute of the Caribbean, Kingston, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Goha","sequence":"additional","affiliation":[{"name":"Cardiology department, Cardiac Center Hail, Hail, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Obiora","family":"Egbuche","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Wexner Medical Center, Ohio State University, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Nunura","sequence":"additional","affiliation":[{"name":"Heart Institute of the Caribbean, Kingston, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest","family":"Madu","sequence":"additional","affiliation":[{"name":"Heart Institute of the Caribbean, Kingston, Jamaica"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"bibr1-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu081"},{"key":"bibr2-10815589221142195","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1337"},{"key":"bibr3-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.12.036"},{"key":"bibr4-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs270"},{"key":"bibr5-10815589221142195","volume-title":"Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division","author":"World Health Organization","year":"2019"},{"key":"bibr6-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13386"},{"key":"bibr7-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X16689444"},{"key":"bibr8-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2007.131060"},{"key":"bibr9-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003497"},{"key":"bibr10-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.501"},{"key":"bibr11-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12726"},{"key":"bibr12-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.008"},{"key":"bibr13-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001981"},{"key":"bibr14-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13172"},{"key":"bibr15-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-12-23"},{"key":"bibr16-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.02.043"},{"key":"bibr17-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2021.01.012"},{"key":"bibr18-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-316648"},{"key":"bibr19-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60518-1"},{"key":"bibr20-10815589221142195","volume-title":"Pregnancy mortality surveillance system | Maternal and Infant Health","author":"Centers for Disease Control and Prevention","year":"2020"},{"key":"bibr21-10815589221142195","volume-title":"Saving lives, improving mothers\u2019 care: lessons learned to inform future maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2009\u20132012","author":"Knight M","year":"2017"},{"key":"bibr22-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.01.039"},{"key":"bibr23-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.08.071"},{"key":"bibr24-10815589221142195","doi-asserted-by":"publisher","DOI":"10.5334\/gh.404"},{"issue":"7","key":"bibr25-10815589221142195","volume":"13","author":"Kumari A","year":"2021","journal-title":"Cureus"},{"key":"bibr26-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr218"},{"key":"bibr27-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq200"},{"key":"bibr28-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1161\/hc3001.093437"},{"key":"bibr29-10815589221142195","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2016-008"},{"key":"bibr30-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000746"},{"key":"bibr31-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2009.03.008"},{"key":"bibr32-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144385"},{"key":"bibr33-10815589221142195","volume":"11","author":"Hameed A","year":"2017","journal-title":"Calif Maternal Qual Care Collab"},{"key":"bibr34-10815589221142195","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6818e1"},{"key":"bibr35-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.05.011"},{"key":"bibr36-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-021-02377-9"},{"key":"bibr37-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2018.12.007"},{"key":"bibr38-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008039"},{"key":"bibr39-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.033465"},{"key":"bibr40-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(16)30065-1"},{"key":"bibr41-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2011.01520.x"},{"key":"bibr42-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmaa115"},{"key":"bibr43-10815589221142195","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3644"},{"key":"bibr44-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665111003077"},{"key":"bibr45-10815589221142195","volume-title":"The confidential enquiry into maternal and Child health (CEMACH). Saving mothers\u2019 lives: Reviewing maternal deaths to make motherhood safer 2003\u20132005. The seventh report of the confidential enquiries into maternal deaths in the UK","author":"Bowyer L.","year":"2008"},{"key":"bibr46-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001831"},{"key":"bibr47-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2012.07.092"},{"key":"bibr48-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-016-0176-x"},{"key":"bibr49-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2017.05.004"},{"key":"bibr50-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.10.005"},{"key":"bibr51-10815589221142195","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.157024"},{"key":"bibr52-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-020-00503-x"},{"key":"bibr53-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6920-14-25"},{"key":"bibr54-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.04.001"},{"key":"bibr55-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey006"},{"key":"bibr56-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2015.05.111"},{"key":"bibr57-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2014.03.006"},{"key":"bibr58-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1007\/s40477-017-0246-5"},{"key":"bibr59-10815589221142195","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.08.010603"},{"key":"bibr60-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.afjem.2020.04.011"},{"key":"bibr61-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.118.004881"},{"key":"bibr62-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.06.004"},{"key":"bibr63-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu296"},{"key":"bibr64-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.01.023"},{"key":"bibr65-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"bibr66-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2006.00240.x"},{"key":"bibr67-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2015.07.023"},{"key":"bibr68-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12956"},{"key":"bibr69-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002406"},{"key":"bibr70-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2011.11.007"},{"key":"bibr71-10815589221142195","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2013.9.16185"},{"key":"bibr72-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2012-201789"},{"key":"bibr73-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1186\/1476-7120-7-41"},{"key":"bibr74-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1097\/00004424-196709000-00017"},{"key":"bibr75-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1186\/s13089-018-0093-4"},{"key":"bibr76-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2019.12.009"},{"key":"bibr77-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2018.03.007"},{"key":"bibr78-10815589221142195","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.06.033"}],"container-title":["Journal of Investigative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10815589221142195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10815589221142195","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10815589221142195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:39:43Z","timestamp":1777459183000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10815589221142195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":78,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1177\/10815589221142195"],"URL":"https:\/\/doi.org\/10.1177\/10815589221142195","relation":{},"ISSN":["1081-5589","1708-8267"],"issn-type":[{"value":"1081-5589","type":"print"},{"value":"1708-8267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,23]]}}}