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Dr. Andrew Rynne

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What causes elevated D-dimer titres?

Answered by
Dr.
Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 2929 Questions

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Posted on Tue, 23 Aug 2016 in Blood Disorders
Question: I have an elevated Ddimer of 2809, fatigue, shortness of breath, and chest pain but all my other lab work, chest x-Ray, ultra sounds, and echo are normal. Can a person just have an elevated Ddimer with no other medical issues going on?
doctor
Answered by Dr. Saddiq Ulabidin 2 hours later
Brief Answer:
Need to have CT PA and some blood work up

Detailed Answer:
Hi! Welcome to health care magic! Thanks for sharing your concerns with us. We will try to help you in best way possible.

Based on the history you have shared, and with associated symptoms and raised D dimers, these can't be ignored at all. Normal Echo and chest Xray may not exclude possibility of a pulmonary embolism. If you had normal CT scan of chest or CT PA because normal CT can even miss that. Symptoms of shortness of breath with raised D dimers makes it highly suspicious.

D dimers cam also be raised in renal disease, infections or formations of clots else where. You may also need to have blood screens with renal functions tests and complete blood picture and sepsis panel including lactate and fibrinogen.

If no focus of infection is known and no such symptom exist, then detailed examination of lower limbs by a doctor to look for any deep venous thrombosis and may be asked for venous doppler to exclude that. Once these are excluded, only then you can safely suggest some thing benign to be the cause.

It is good however that chest Xray and Echo is normal. Since you had been given inhalers and brochodilators so it could have been some chest brochospasm which had been causing shortness if breath and such symptoms may be caused by bronchitis which if infective will also raise D dimers. Keep a record of D dimers by repeating it weekly atleast unless infection isn't completely resolved or other causes have been ruled out.

Hope this has answered your query, if you have any more questions, feel free to ask. Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Saddiq Ulabidin 2 hours later
Thank you, I also had an cardiac echo and had an ejection fraction of 81% could that have anything to do with my symptoms?
doctor
Answered by Dr. Saddiq Ulabidin 15 hours later
Brief Answer:
It is a good sign

Detailed Answer:
Hi! Thanks for sharing your feedback. The report of echo is not showing any signs of increased pulmonary artery pressures and that is a good sign however like I said earlier pulmonary embolism isn't completely ruled out yet. Your symptoms with raised D dimer needs further evaluation with the tests we have mentioned before.

Wishing you a speedy recovery.
Regards.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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