The purpose of this study is to develop a pilot screening protocol, comparing cardiac point-of-care ultrasound (POCUS), electrocardiogram (EKG), serum biomarkers (N-terminal pro b-type natriuretic peptide (NT-proBNP), high sensitivity troponin (hsTn)) with formal transthoracic echocardiogram (TTE) in pregnant women with methamphetamine use.

This is a pilot study that examines previously undiagnosed cardiac pathology utilizing transthoracic echocardiogram (TTE) in pregnant women with chronic methamphetamine use and assesses possible screening modalities (cardiac point-of-care ultrasound (POCUS), serum biomarkers, electrocardiogram (EKG)) in identifying underlying disease in this population. As this is a prospective observational study, we will assess pregnancy-related complications and care connections in the pilot tertiary academic setting.

Inclusion Criteria:

• 18 years or older > 20 weeks gestation admitted to the hospital
• Active patient-defined regular methamphetamine use for at least 1 year and any use within the last month
• Able to understand and provide informed consent
• Able to understand English

Exclusion Criteria:

These criteria will exclude women whose medications, personal traits, obstetric conditions, or diseases could confound cardiovascular risk.

• Prescribed stimulants
• Echocardiogram or EKG previously performed during current pregnancy
• Previous diagnosis of congestive heart dysfunction
• Previous diagnosis of pulmonary hypertension
• Previous myocardial infarction
• Previous diagnosis of endocarditis
• Prior cardiac intervention (repair of cardiac congenital lesion, valve replacement or repairs, percutaneous/operative treatment of arrhythmias)
• High-risk aortopathy (Marfan syndrome, bicuspid aortopathy, prior aortic dissection)

Pregnant women > or equal to 20 weeks gestation presenting to OHSU for hospital, day patient, or observation admission will be identified via the electronic medical record.