Pulmonary Embolism Support Group

By far the most common form of pulmonary embolism is a thromboembolism, which occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. Symptoms may include difficulty breathing, pain during breathing, and more rarely circulatory instability and death.

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D-Dimer Help

Daffnae
Daffnae
I've been having chest pains off and on for 3 weeks now. My guess is that they are related to jogging and/or anxiety. My PE was 11 months ago. The last time I had pain in my lungs was back in November.

I'm traveling quite a bit for work, and finally yesterday I decided I should stop guessing and go see someone about my chest pains, so I went to urgent care and asked for a D-Dimer. All other vitals are excellent, including EKG.

My D-Dimer result was 0.2. According to the nurse that called me back this is less than the threshold where there is concern about PE. She instructed me to see a primary care physician if the feeling worsened or persisted. I explained my situation and that it has been 3 weeks of this and that I'm hopping on a plane tomorrow. She suggested I try to see someone today as a follow-up and didn't feel that the result was conclusive.

My question is: is a value of "0.2" considered a negative d-dimer reading where I can feel confident that I don't have any clotting going on? Or am I really no closer to ruling out a PE?

I have a call in to my doctor to get his thoughts on it, but thought I'd throw the question out to the group as well.

Thanks!
rmb
rmb
I think sometimes the range used can vary but according to this link below, anything below 300 nanograms/milliliter would be normal, but I've seen the cut off at 500 as well.

http://www.medicalhealthtests.com/blood-tests/d-dimer-blood-test.html

But this is just in general. There may be more to evaluating the possible presence a clot than just the D Dimer.
TossNTurn
TossNTurn
Hard to say for sure, since it seems like every version of the d-dimer test uses slightly different numbers. Wish I could tell you for sure, but my doctor refuses to run a d-dimer on me because she thinks the chronic DVTs in my legs will skew the numbers. Keep in mind that there are a lot of reasons you can get a high d-dimer. Even if it was higher, no guarantee that you're clotting.

Good to check in with your doc, for sure. And, for your own peace of mind take all the usual precautions on the flight tomorrow. (Stay hydrated, tap feet, get up and walk a couple of times, stockings possibly).
rmb
rmb
Yeah that's true. If you have clots already present and /or are on anticoagulants, both can skew the results anyway.
Daffnae
Daffnae
Thanks! I appreciate your responses. I've been off warfarin for almost 6 months. Hopefully I hear back soon. I really don't think I have any clots, but I will certainly be taking the normal precautions (and more). On the bright side, my business trip is visiting a hospital, so I will at least be close to an ER if needed once I get there.
deleted_user
deleted_user
Last time my doctor sent me to the ER for a CT scan, my d-dimer was "elevated" at 0.6, and the ER doctor told me anything 0.5 or below was negative, so I was very questionably positive and had I not clotted before, they probably would not have even considered a CT. I had been sick for a few days, so after a clear chest CT, the doctor credited my slightly elevated level with a virus. That visit was 6 months ago now, so I'm pretty confident they were right about the virus! :)
Daffnae
Daffnae
Thanks for sharing your experience. I heard back from the doctor, and he was essentially vague. The one thing I noticed was that his response was not that I should run off to the ER. Instead, they didn't want to say I shouldn't go...and that I should go if I was still concerned. My decision is to not go to the ER. Instead I'm going to scale back my jogging and see if the pains go away. From what I can tell, the d-dimer of 0.2 is really quite low, and while not conclusively telling us anything, it isn't raising a huge alarm with my doctors (combining this with my vitals and exercise levels).
Lynnedz56
Lynnedz56
Glad you got some kind of answer. However, my doctors tell me that once you have a clot, the D-Dimer is useless as a guide. The ER doesn't even run mine anymore, since it is now of no value. A VQ scan can be used, but it can also be flawed once you have a PE.
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