D-dimer is a protein fragment found in the blood during the breakdown of blood clots as soon as an injury heals. In certain blood clotting disorders like deep vein thrombosis, pulmonary embolism disseminated intravascular coagulation, and stroke, D-dimer levels are raised in the blood. Apart from these disorders, the values are increased in COVID-19, pregnancy, recent surgery, and heart disease. D-dimer has its name derived from its structure of two D fragments of fibrin protein connected by a cross-link. An average D-dimer level is considered to be less than 0.5 mg/L.
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My wife undertook the D-dimer test for her chronic chest and abdominal pain, which showed an elevation. Why?
Query: Hello doctor, My wife has been having chest and abdominal pain for several years. Recently, the doctor asked us to take a D-Dimer test, and the result came up 1.14, and after we visited the doctor, she asked us to take a VQ scan scheduled in a week. I got so scared learning about the D-Dimer test w... Read Full »
Dr. Goswami Parth Rajendragiri
Answer: Hello, Welcome to icliniq.com. I read your query and can understand your concern. In pulmonary embolisms like thrombotic events, D dimer can be elevated. Therefore, you can have pulmonary embolism as D dimer is elevated and chest pain is present. Therefore, VQ (ventilation–perfusion) scan or MRI ... Read Full »
What caused the four-second arrhythmia when I stood up?
Query: Hello doctor, I am a 17-year-old male. About a month ago, I passed out after watching a movie first responders came and said I was fine until they asked me to stand up, and that is when a four-second arrhythmia occurred. I was rushed to the emergency room and was told I needed a pacemaker, and the... Read Full »
Answer: Hi, Welcome to icliniq.com. Thanks for the query. The transient loss of consciousness with loss of postural tone but with spontaneous and complete recovery is called syncope. The most common in the general population is vasovagal syncope. Please answer some questions so that I may rule out the ca... Read Full »
What is peripheral artery disease?
Query: Hi doctor, I am a 33 year old female. I have never smoked. I am not overweight and I do not have diabetes. I have been having some left leg issues. It started six months back. I started limping because my left calf, ankle and groin were hurting. My emergency Doppler venous ultrasound was clear. I ha... Read Full »
Answer: Hi, Welcome to icliniq.com. From your description, I understand that the first time you had a problem with your left leg was due to a sprain (talofibular ligament) around the ankle and it got resolved. I suspect the same problem or something similar is causing you the pain again. It is highly un... Read Full »
I had a knee replacement after a car accident, and my D-dimer levels have never improved. Could it be due to a post-operative infection?
Query: Hi doctor,I encountered a motor vehicle accident one and a half years back. My right femur was broken above the knee. I had major surgery, including a knee replacement. I have never recovered. My D-dimer levels have been elevated for over a year now. I do not have a blood clot. Do you believe I have... Read Full »
Answer: Hello, Welcome to icliniq.com. I went through your query and understood your concern. Let me explain to you about the D-dimer levels. Elevated plasma D-dimer indicates that coagulation has been activated, a fibrin clot has formed, and clot degradation by plasmin has occurred. There are many causes ... Read Full »
My D-dimer is 1.28 ug/ml. Should I continue to pursue the D-dimer?
Query: Hello doctor, I got blood work for recurrent chest pain. All was normal, but my D-dimer was 1.28 ug/ml (normal below 0.50). Chest CT with contrast normal, doppler u/s both legs normal, abdomen/pelvic CT, as well as abdominal ultrasound normal. The doctor says not to worry about D-dimer, but it was n... Read Full »
Answer: Hello, Welcome to icliniq.com. I think we should retest D-dimer maybe after a few weeks, three to four weeks. This is to see the trend and confirm the elevated levels. The usual causes for elevation include DVT (deep vein thrombosis), pulmonary embolism, infection, stroke, trauma, and rarely some ... Read Full »
Does my D-dimer level of 1.35 mg/L indicate blood clots in my body?
Query: Hello doctor, Recently, my D-dimer levels were 1.35 mg/L. Two months back, they were 1.49 mg/L. I have severe stress and anxiety and am sensitive to salt and sugar. I get chest pain when I consume salty foods. My blood pressure goes up occasionally. However, I do not have shortness of breath. Also,... Read Full »
Dr. Goswami Parth Rajendragiri
Answer: Hello, Welcome to icliniq.com. I understand your concern. Following is my opinion on your questions. CT (computed tomography) angiography or invasive angiography can detect a heart clot. A stress test does not detect a clot. Sometimes, chronic hypertension induces vessel damage, inflammation, an... Read Full »
Will Propranolol help me lower my blood pressure?
Query: Hello doctor, I had hip pain mostly related to sciatic and hip muscle pain. The doctor gave me Methylprednisolone 1000 mg of yesterday. The pain subsided, but blood pressure slightly elevated at 135/75 and heartbeat at 110 to 120. Earlier, it was 125/80, and the heartbeat was at 90 to 95. I feel a s... Read Full »
Answer: Hello, Welcome to icliniq.com. You are having this tachycardia and hypertension due to the intake of steroids in a high dose. Once when you are off the medicine, your vitals will normalize. There is no need to take any anti-hypertensives. For a fast heart rate, I suggest you take the tablet Metopr... Read Full »
Is it possible to have a pulmonary embolism with a negative D-dimer test?
Query: Hi doctor, My pain started behind knee, but now is causing recurrent chest pains and shortness of breath. I could not do much physical activity. There is no previous history of such event. I am currently on Aspirin. I had an EKG, lung x-ray and D-dimer blood test. Is it possible to have a pulmonary ... Read Full »
Answer: Hello, Welcome to icliniq.com. D-dimer is a very desirable indicator of clot formation. It may be positive even if you do not have a pulmonary embolism. But, if D-dimer is normal, then a pulmonary embolism is unlikely the cause of your symptoms. Pulmonary embolism can cause sudden onset of sh... Read Full »
I am worried about if my chest X-ray has any nodules of concern. Please help.
Query: Hello doctor, I am looking for a second opinion regarding my chest x-ray. The chest x-ray showed no masses, nodules or pneumonia. I just have a very mild inflammation and an old rib injury. The doctor told me that I had heart deformities, but I already knew about those. Read Full »
Answer: Hello, Welcome to icliniq.com. I have seen your x-ray reports (attachment removed to protect patient identity). There appears to be a mild prominence of the bronchovascular markings in both the lungs, more so in the lower lobes. This is not a serious problem and sometimes can occur without any acc... Read Full »
Why is my D-dimer level elevated after the first dose of my COVID vaccine?
Query: Hello doctor,I do not have any symptoms, but my D-dimer level are very high. I do not have any history of vascular disease, pulmonary embolism, or blood clots. My question is, I discovered the D-dimer elevation three weeks after my first COVID-19 vaccine. Can I get my second dose if I still have hig... Read Full »
Answer: Hi, Welcome to icliniq.com. I hope you are doing well in the pandemic. As you said, you have no signs and symptoms of any disease, and you have got vaccinated a few months back, and your D-dimers are pretty high, indicating that you have some low to intermediate grade clotting state. And, as... Read Full »