Which studies are used to diagnose postpartum cardiomyopathy?

• A. Echocardiogram and BNP
• B. Troponin only
• C. CXR alone
• D. ECG alone

Answer: (A)

Diagnosing postpartum cardiomyopathy hinges on showing heart failure with actual impairment of the heart’s pumping ability, not just signs or single tests. The key is echocardiography to assess cardiac function directly—look for left ventricular systolic dysfunction, such as a reduced ejection fraction and possible chamber dilation. Adding a measurement of BNP helps confirm heart failure physiology, since BNP rises with ventricular stretch and volume overload, supporting the diagnosis in the postpartum period.

Relying on troponin alone doesn’t establish PPCM because it indicates myocardial injury rather than the functional impairment of systolic dysfunction. Chest X-ray or an ECG by themselves can be non-specific and don’t quantify the pumping function needed to diagnose PPCM. Therefore, echocardiography plus BNP is the most informative combination for diagnosing postpartum cardiomyopathy.