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Calf pain, chest pain, anxiety. Elevated d dimer test. Could I have pulmonary embolism?

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Oncologist
Practicing since : 2002
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im 23 female. recently i went on a long haul trip about 13 hours, i did get out a few times during my trip. I went to the emergency room this morning for calf pain. I had a ultrasound which showed no clots. But a slightly elevated d dimer test. I have anxiety and this afternoon have developed some chest pain in the center of my chest. Ive had countless negative d dimers in the past and never had any that were elevated, as well as a ct scan of my lungs with contrast that was negative and many negative leg scans. Should I go back to the ER? could I have a pulmonary embolism
Posted Thu, 3 May 2012 in Lung and Chest disorders
 
 
Answered by Dr. Robert Galamaga 12 minutes later
Hello and thanks for the query.

Your question is a very good one and I will work on providing you with some good information and recommendations regarding what is going on.

First of all let me reassure you that I am very confident that you do not have a pulmonary embolism. I realize the significant degree of anxiety you have about this but I must reassure you that I feel very very confident that you do not have to worry about this.

The fact that your ultrasound of the lower extremity was normal with no evidence of blood clots is very reassuring. Let me off so we are sure you that if a person has a blood clot the dimer level is often very high over 1000 even in some cases. A slightly elevated dimer test is relatively common to experienced in the population. It does not mean that you have any small blood clots forming or anything like that.

For now it is important for you to work on getting your mind off succeeding on the idea of a pulmonary embolism or blood clot. If you are not exercising already I think it is extremely important for you to exercise at least 45 min. per day. This will significantly help your anxiety.
You might also consider performing some meditation or yoga exercises as this will significantly help the stress and anxiety levels.



I thank you again for submitting your question. I hope you found my response to be helpful informative and reassuring. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Robert
Above answer was peer-reviewed by
 
Follow-up: Calf pain, chest pain, anxiety. Elevated d dimer test. Could I have pulmonary embolism? 1 hour later
Thank you for your reply. My level was 545 but he did not say what the normal range was. I am just freaking myself out. If i did have a pe would there have been some evidence of it in my ultrasound? I just dont want to keel over and die from this. The doctor said he didnt think it was a clot anywhere. Im just worried about the chest pain that started this afternoon
 
 
Answered by Dr. Robert Galamaga 27 hours later
Hello and thank you for the follow up question.

Again I am very confident that you would did not suffer anything like a pulmonary embolism or blood clot. If you had a pulmonary embolism there would very likely be evidence of a blood clot in the leg because this is the source of the pulmonary embolism in patients who suffer from them. I am not worried about you having any type of problem with blood clots at this time. I understand that you have a significant degree of worry about this and I would like to try to provide you with as much reassurance as possible.

Regarding chest pain this of course is something that most people worry about. In individuals who are very healthy otherwise some of the more common causes of chest pain include esophageal reflux or anxiety. In your case I would have to consider anxiety to be the most likely contributing factor. Anxiety as well as panic disorder can sometimes cause this type of issue. Again I urge you to try to focus your mind on other types of distractions in order to help mitigate this problem.

Hi thank you again for submitting your question and sharing your health concerns with me. I hope you found some reassurance in my replies. If you have any additional concerns or questions I would be happy to address them.

Sincerely,

Dr. Robert
Above answer was peer-reviewed by
 
Follow-up: Calf pain, chest pain, anxiety. Elevated d dimer test. Could I have pulmonary embolism? 13 hours later
thank you for your reply. I did go toba different er yesterday.had a chest xray and ekg anf my thyroid checked. All was normal. The dr there did not feel.the need to do a repeat test. Or do a ct scan and he assured me i did not have a clot. Im still having anxiety because my chest hurts. The pain is in the midddle and can be intense. It can go to my throat and my ribcage. And it just hurts. Should i still not be concerned?
 
 
Answered by Dr. Robert Galamaga 6 hours later
Hello and thanks for the followup.

I think we are dealing with a mild panic disorder here. Chest pains are very common in this anxiety based disorder. again the best things to do are lifestyle-related including the balanced diet, exercise, yoga and meditation. These surely will hep but it may take a fe weeks to reach a full benefit.

For now I would not be concerned that the symptoms reflect anything serious or life threatening.

You might discuss this with your doctor and he might consider a medication for panic disorder which might help a lot. The one that comes to mind which may be of benefit would be Zoloft or sertraline. I am not saying you absolutely need this medicine but it is a consideration right now.

I hope again that you find some comfort and reassurance in what I am telling you.

Again I thank you for the query. If you have any additional concerns I am here for you.

Sincerely,

Dr. Galamaga
Above answer was peer-reviewed by
 
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