Brief Answer:
No worries, D dimer is non specific, Innocuos

Detailed Answer:
Thank you for asking

Ventilation perfusion is a test done only when CT is not available. CT is far more superior to it. If CT ruled it out then i am sure there is nothing to worry about as per your doctor.

Now the issue of D Dimer elevation, so there are many other conditions apart from Pulmonary EMbolism that may elevate it. Let me explain it.

D-dimer is the degradation product of crosslinked fibrin; therefore, it reflects ongoing activation of the hemostatic system. Since there is constant minimal physiologic fibrin formation and degradation in vivo, healthy individuals have a minimal D-dimer level.

Elevated D-dimer levels reflect ongoing activation of the hemostatic and thrombolytic system, providing clinical utility in the following:

Evaluation of thrombus formation , which you have already been evaluated for.
Ruling out DVT , you already have been ruled out.
Monitoring anticoagulative treatment (a decreasing value indicates effective treatment)
Disseminated intravascular coagulation (DIC) which has been ruled out in your case.
Snake venom poisoning Which is not your case,

Apart from that, D-dimer levels may be elevated in the setting of pregnancy, inflammation, malignancy, trauma, postsurgical treatment, liver disease (decreased clearance), and heart disease. It is also frequently high in hospitalized patients.

Lipemia, a high triglyceride level, an elevated bilirubin level, an elevated serum rheumatoid factor level, or hemolysis may falsely increase the D-dimer level.

Also keep in mind that the D-dimer level increases naturally with age. And you are 56 already. So it may be the factor.

Nutshell, D dimer is nothing to worry about. It rises in so many conditions and is not significant. Just ignore it. Stay in touch with your cardiologist for the chest pains and Dyspnea and let them sort out the other possibilities of this shortness of breath. And we all know that psychologic dyspnea is a predominant case these days.

I hope it helps. Take good care of yourself and dont forget to close the discussion please. may the odds be ever in your favour.

Regards
Khan

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Brief Answer:
D-dimer elevating levels not a matter of concern,

Detailed Answer:
Hi,
i will tell you why d-dimers are used. It is primarily used as a screening test in low probability cases of pulmonary embolism. If its postive, it doesnt mean at all anything wrong, it just means its a green signal for further evaluation. thats it. It has a very poor specificity. If its negative, no further work up. However as in your case you had symtoms of shortness of breath and chest pain, all that d-dimers meant in such a situation that you need to be evaluated further for the diagnosis of Pulmonary embolism. In fact in a clear cut case like yours D-dimers shouldn't be done at all. Since your evaluation for pulmonary embolism which included Ct and V/P does not suggest pulmonary embolism, you don't need to worry. As for D-dimers elevating levels in your scenario, it actually signifies nothing at all, neither it is any specific no a matter of concern. Neiher can you do anything to get the levels down. You need to relax about it. In your case D-dimers levels shouldn't have been done at the first place. As for further evaluation even that would be redundant after what you have been evaluated for , you may undergo duplex US of the legs from where the emboli usually takes it origin. Hope it helps.
Dr. Khan

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