Elevated D-Dimer; No Pulmonary Embolisim

[Diskid86]

I'm a 31 year old female who found myself in the ER (again) yesterday with chest pains, and periodic episodes of dry cough and shortness of breath that come on suddenly, often when I'm not doing anything strenuous - I can get short of breath putting dishes away but later in the day run on the cross trainer at the gym and don't have a problem. Anyway, chest X-ray and CMP, CBC, etc were all good, but I had an elevated D-Dimer (I'm not sure by how much), and one of the nurses thought my legs looked swollen, though I'm not sure they looked any different to me (but I don't spend a lot of time looking at my legs... so). Anyway, I was sent of for a CTA which came back clear. They want me to follow up with my PCP and Cardiologist. Not sure what a D-Dimer was, I looked it up, and positive ones don't seem to have many good outcomes. My health has been in nosedive since August - and in combo with the d-dimer, now this has me worried about things like cancer. I'm not pregnant, haven't fallen recently, and haven't had recent surgery, so none of the benign things that can cause it seem to apply to me.

Does anyone have any experience with elevated d-dimer in a younger patient not being related to some life threatening condition?

The following will be long and maybe isn't necessary - but in case my recent health background helps.... in July/August I made some dietary macro changes to try to encourage fat loss while retaining muscle and immediately felt unwell. I would go home and binge eat later on carbs since I'd greatly reduced them and then feel even worse for up to four days later.... gassy, lightheaded, crampy, bloated, incredibly fatigued. Eventually I gave up and switched back to how I had been eating (Mediterranean Diet) - and immediately felt better. A month later I developed a stiff neck ( I work a desk job and am hunched over all day assembling stuff, so I didn't think much of it). Then in August I was sitting at my work desk and almost passed out. About a week and a half later after continued episodes I was admitted into the hospital and diagnosed with epilepsy, much to everyone's surprise as they said what I was describing didn't sound like a seizure and I had no personal or family history of seizures. That said, Keppra seems to help these episodes. Upon admittance to the hospital I developed high pitched ear ringing that hasn't gone away since, though it does switch ears, changes pitch, volume, etc. Upon discharge I developed lower back pain, which I attributed to weird sleeping positions in the hospital bed - it hasn't gone away either. From then until now I've suffered with periodic bouts of tingling in hands or feet, vertigo, shortness of breath, dry cough often preceded by a tickle in the throat, difficulty swallowing, nausea, muscles feeling weaker, fatigue, return of gastrointestinal symptoms (abdominal pain, changes in bowl habbits/appearance, bloating, gas, pain when pressing on my lower abdominal area - I'm currently seeing a GI to figure out what is going on) - and excessive bleeding (I started taking baby aspirin after almost passing out that first time because the first thing that came to mind was a stroke - and since then I've been bleeding excessively when having blood drawn - soaking through the gauze pad and having blood going all over my arm and down my leg). The change bothered me enough that the past few days before the elevated d-dimer I stopped use of the aspirin because I was afraid it was causing me to excessively bleed (so I don't know if cessation of aspirin use can cause the d-dimer to elevate or not?). Other than that I do have past history of asthma (which I supposedly grew out of am not medicated for), mitral valve prolapse (my last cardiologist appointment was around this time last year and my heart function had actually improved with weight loss and exercise), Graves Disease (thyroid function is currently normal), thyroid goiter and nodule (hasn't been evaluated in a few years via scan, but everything felt normal to my endocrinologist 6 months ago), history of proctitis, endometriosis, ovarian cysts, history of hepectic adenoma with elevated liver enzymes; though recently I think my liver values have all checked out ok. Any ideas at all?

[b1b1b1]

What is D dimer?

[Damian]

According to Google there seem to be various things that would give a positive d-dimer test, but in my experience it's common to get odd test results and symptoms for no reason at all. You go to the doctor, you get an odd test result, and that triggers all sorts of investigations which eventually lead nowhere. No one really knows where the odd result came from and you're not ill.

If you're prone to anxiety, it's a particular problem because you end up getting tested for all sorts of things and just because of bad luck some of them will come back positive, even though there's nothing wrong. That triggers hospital appointments and scans and all sorts, which makes your anxiety worse.

Of course I'm not saying you should ignore the result. You should get whatever tests they recommend, but I think there's a good chance they'll eventually decide there's nothing wrong. I've had this happen several times.

Good luck!

[mrmonk]

Hello Diskid86,

I'm in my mid 40s, and I've had an elevated d-dimer discovered twice after going to the ER for chest pains, tachycardia (which turned out to be SVT), and shortness of breath. The first time, they did a pulmonary CTA and ultrasounds of my legs -- all clear. The second time, several months later, they wanted to do a CTA again, but I declined because I've had so many CTs in the past two years, I know the radiation is doing more harm than good. Afterward, I had a repeat d-dimer test done through my primary care doctor, and the results were normal. Since an elevated d-dimer could indicate anything from inflammation to PE to cancer, the best thing you can do is what you are already doing -- stay vigilant and keep consulting your doctors.

[Cjohnson1001]

I also had an elevated d-dimer when I went to the ER for odd symptoms of tachycardia, heavy feeling in arms, dizziness. When I was there I developed a tickle in my throat and a rash. I also had some diarrhea. CT was normal. Turns out I was having an anaphylactic reaction to some digestive enzymes I had taken. Repeat d-dimer 1 month later was normal. The elevation was due to the allergic reaction. With your symptoms, maybe you are allergic to something?