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Suggest Treatment For Abdominal Pain, Diarrhea And Pressure In The Chest
Question: Hi I have been to the ER 4 times in the last 5 days with increased pouding HR, abdominal pain w/ diarrhea and tightness in my chest and abdomen, also my neck. Sometimes I feel like I can be short of breath, but I am able to breathe fine. I have had EKGs done numerous times this week to rule out arrhythmias. All the EKGs are normal except for the first one which was sinus tacky. All of my labs came back normal as well. I was overall just told I am having anxiety and referred to psychology. Well yesterday, I wasn't feeling well again and felt like my heartbeat was irregular. I went to the ER again and my EKG was normal, the doctor listened to my heart again and it sounded fine, but it didn't feel fine to me. I also have a heart monitor that has not reported any abnormal rhythms. They drew a d-dimer last night just to make sure I was not having a PE due to my complaints of tightness in the chest. The MD told me everything was normal and I was sent home. The next morning I get a call that the lab did my d-dimer and it was actually elevated at 600 and that I need to come back in, which I did. Basically I did not exhibit any s/s of a PE other than the elevated d-dimer (which they stated was not 'that' elevated anyway), so they did nothing and sent me home again. My concern is, what could cause my d-dimer to be elevated?? Should I be alarmed?
Brief Answer:
Nonspecific test
Detailed Answer:
Hi,
Firstly thanks for choosing health care magic for your query!
Pulmonary embolism occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs. These blood clots most commonly come from the deep veins of your legs. This condition is known as deep vein thrombosis,Deep vein thrombosis is very common in chronic smokers.
D-dimer is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.D-dimer concentration
help diagnose thrombosis.
D dimer is a very non specific test,It can ge elevted in a numbe of conditions like-
Venous thromboembolism,deep vein thrombosis or pulmonary embolism.Specificity of D dimer test is very low.
Recent trials shows that out of positive D-dimer test for 1647 patients,Embolism was the cause of positive D-dimer test for 257 (15.6 %) patients only, others were syncope, 155 (9.4 %) patients; heart failure, 146 (8.9 %) patients; trauma, 135 (8.2 %) patients; and cancer, 95 (5.8 %) patients.
Hence dimer is a very unspecific test ,If embolism is suspected ed echo should be done and Doppler of leg should be done to rule out DVT.
Because of low specificity of test D-dimer elevation >3000 ng/mL is considered significant,yours was 600 which is very low ,hence your doctor sent you back home.
In case you have any other query feel free to ask!
Thanks.
Nonspecific test
Detailed Answer:
Hi,
Firstly thanks for choosing health care magic for your query!
Pulmonary embolism occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs. These blood clots most commonly come from the deep veins of your legs. This condition is known as deep vein thrombosis,Deep vein thrombosis is very common in chronic smokers.
D-dimer is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.D-dimer concentration
help diagnose thrombosis.
D dimer is a very non specific test,It can ge elevted in a numbe of conditions like-
Venous thromboembolism,deep vein thrombosis or pulmonary embolism.Specificity of D dimer test is very low.
Recent trials shows that out of positive D-dimer test for 1647 patients,Embolism was the cause of positive D-dimer test for 257 (15.6 %) patients only, others were syncope, 155 (9.4 %) patients; heart failure, 146 (8.9 %) patients; trauma, 135 (8.2 %) patients; and cancer, 95 (5.8 %) patients.
Hence dimer is a very unspecific test ,If embolism is suspected ed echo should be done and Doppler of leg should be done to rule out DVT.
Because of low specificity of test D-dimer elevation >3000 ng/mL is considered significant,yours was 600 which is very low ,hence your doctor sent you back home.
In case you have any other query feel free to ask!
Thanks.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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