D-Dimer | Healthmatters.io (2024)

Also Known As: Fragment D-dimer // Fibrin Degradation Fragment

Quick summary:

A D-dimer test is most often used to find out whether you have a blood clotting disorder. These disorders include:

- Deep vein thrombosis (DVT), a blood clot that's deep inside a vein. These clots usually affect the lower legs, but they can also happen in other parts of the body.

Symptoms of DVT include:

- Leg pain or tenderness

- Leg swelling

- Redness or red streaks on the legs

- Pulmonary embolism (PE), a blockage in an artery in the lungs. It usually happens when a blood clot in another part of the body breaks loose and travels to the lungs. DVT clots are a common cause of PE.

Symptoms of PE include:

- Trouble breathing

- Cough

- Chest pain

- Rapid heartbeat

- Disseminated intravascular coagulation (DIC), a condition that causes too many blood clots to form. They can form throughout the body, causing organ damage and other serious complications. DIC may be caused by traumatic injuries or certain types of infections or cancer.

- Stroke, a blockage in the blood supply to the brain.

---------------------------------------

What is D-Dimer?

D-Dimer is one of the protein fragments produced when a blood clot gets dissolved in the body. It is normally undetectable or detectable at a very low level unless the body is forming and breaking down blood clots. Then, its level in the blood can significantly rise. A D-dimer test is a blood test that can be used to help rule out the presence of a serious blood clot.

What is hemostasis and blood clots?

When a blood vessel or tissue is injured and begins to bleed, a process called hemostasis is initiated by the body to create a blood clot to limit and eventually stop the bleeding. This process produces threads of a protein called fibrin, which link together to form a fibrin net. That net, together with platelets, helps hold the forming blood clot in place at the site of the injury until it heals.

What is plasmin?

Once the area has had time to heal and the clot is no longer needed, the body uses an enzyme called plasmin to break the clot (thrombus) into small pieces so that it can be removed. The fragments of the disintegrating fibrin in the clot are called fibrin degradation products (FDP), which consist of variously sized pieces of crosslinked fibrin. One of the final fibrin degradation products produced is D-Dimer, which can be measured in a blood sample when present. Normally, with a little time, D-dimer goes away. But you can get high levels of D-dimer in your blood if you have a major clot like with deep vein thrombosis (DVT). With DVT, you have a clot deep in one of your veins, usually in your legs, and it can lead to serious problems.

When can D-Dimer levels rise?

The level of D-Dimer in the blood can significantly rise when there is significant formation and breakdown of fibrin clots in the body.

However, a positive D-Dimer test cannot predict whether or not a clot is present. It indicates that further diagnostic procedures are required (e.g., ultrasound, CT angiography).

Factors associated with inappropriate blood clot formation:

There are several factors and conditions associated with inappropriate blood clot formation. One of the most common is deep vein thrombosis (DVT), which involves clot formation in veins deep within the body, most frequently in the lower legs. These clots may grow very large and block blood flow in the legs, causing swelling, pain, and tissue damage. It is possible for a piece of the clot to break off and travel to other parts of the body. This "embolus" can lodge in the lungs, causing a pulmonary embolus or embolism (PE). Pulmonary embolisms from DVT affect more than 300,000 people in the U.S. each year.

Where do clots form and why test for D-Dimer?

While clots most commonly form in the veins of the legs, they may also form in other areas as well. Measurements of D-Dimer can be used to help detect clots in any of these sites. For example, clots in coronary arteries are the cause of myocardial infarction (heart attacks). Clots may form on the lining of the heart or its valves, particularly when the heart is beating irregularly (atrial fibrillation) or when the valves are damaged. Clots can also form in large arteries as a result of narrowing and damage from atherosclerosis. Pieces of such clots may break off and cause an embolus that blocks an artery in another organ, such as the brain (causing a stroke) or the kidneys.

Normal levels: If your results show low or normal D-dimer levels in the blood, it means you probably don't have a clotting disorder.

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D-Dimer | Healthmatters.io (2024)

FAQs

What is a concerning level of D-dimer? ›

A normal D-dimer is considered less than 0.50. A positive D-dimer is 0.50 or greater. Since this is a screening test, a positive D-dimer is a positive screen.

Why is my D-dimer high but no blood clot? ›

High D-dimer levels are not always caused by clotting disorders. A few other possible reasons why you may have high D-dimer levels include pregnancy, heart disease, rheumatoid arthritis, and recent surgery. Being older or immobilized (unable to move) may also cause a high D-dimer level.

How do you treat elevated D-dimer? ›

A positive d-dimer test requires further work-up, including imaging tests to diagnose the underlying cause. Treatment of a high d-dimer depends on the cause and can include anticoagulants, thrombolytics, and thrombectomy.

How long does D-dimer stay elevated? ›

D-dimer has a half-life of 4-6 hours and stays elevated for about seven days. Once the clot organization and adherence begins, levels of D-dimer drop. As such, D-dimer levels correlate with the presence of fibrin clots.

Can anxiety cause elevated D-dimer? ›

In humans, stressful situations can trigger the clotting system, leading to increases of D-dimer in blood (von Känel et al., 2009; Austin et al., 2013).

What type of inflammation causes high D-dimers? ›

Several diseases are characterized by low-grade chronic inflammation and thus high D-dimer; the most common are autoimmune diseases and diabetes.

What autoimmune disease causes high D-dimer? ›

Increases in plasma D-dimer levels have been reported in various autoimmune vasculitis conditions, including antineutrophil cytoplasmic antibody-associated vasculitis39, cutaneous polyarteritis nodosa29, Takayasu's arteritis40, eosinophilic granulomatosis with polyangiitis41 and IgA vasculitis42.

What cancers cause high D-dimer? ›

This suggests that elevated D-dimer levels in patients with VTE and malignancy are not solely due to presence of thrombus. High D-dimer levels in malignancy are likely to reflect the biology of the underlying tumour, with higher levels observed in breast, prostate and bowel cancers.

What kind of trauma causes high D-dimer? ›

Patients with moderate and severe head trauma develop progressive disorders of the coagulation and fibrinolysis systems. D-dimer, a product of clot degradation by the fibrinolytic system, is markedly elevated with increased fibrinolysis [6].

What are the five warning signs of a blood clot? ›

Warning Signs and Symptoms of Blood Clots
  • Swelling in the leg or arm.
  • Tenderness or cramps in the leg.
  • Out of breath, or shortness of breath.
  • Passing out or feeling lightheaded.
  • Chest pain or back pain when breathing.
  • Leg discoloration, either a red or blue hue.
  • Overdrive, when your heart is racing.
  • Time to call 911.
Apr 13, 2022

Can exercise lower D-dimer? ›

In a prospective study of 42 sailors, D-dimer levels were drawn before and after a workout that simulated the standardized Navy Physical Readiness Test. Data were analyzed using the Kruskal-Wallis and Kolmogorov-Smirnov tests. No significant change was found between pre- and postexercise levels.

Can you ignore high D-dimer? ›

In conclusion, an extremely elevated D-dimer is specific for serious illness and should trigger suspicion of severe disease, particularly VTE, sepsis or cancer, the last of which even in the presence of VTE.

When should I be worried about my D-dimer? ›

What does a high D-dimer test result mean? If your results reveal that you have higher-than-normal levels of D-dimer in your blood, it may mean that you have a blood clotting condition. A D-dimer test can't determine the type of blood clotting condition you may have or where the blood clot(s) is in your body.

What can cause an elevated D-dimer besides a clot? ›

D-dimer levels can be positive due to:
  • Being over 80 years old.
  • Heart disease.
  • High lipid or triglyceride levels.
  • Liver disease.
  • Pregnancy.
  • Recent surgery or trauma.

Can dehydration increase D-dimer? ›

No, it does not. But becoming dehydrated lowers blood volume, and this makes your blood 'thicker' raising your risk for blood clots if you are predisposed.

Is elevated D-dimer an emergency? ›

Blood clotting conditions can be serious and life-threatening. Having a high D-dimer level in your blood can be a sign of a blood clotting disorder since the level of D-dimer can rise greatly when there's significant formation and breakdown of blood clots in your body.

Is 700 a high D-dimer? ›

A normal result would be less than 500 nanograms per milliliter (ng/mL) and anything above that is considered a positive test. 1 It's useful if your doctor suspects you have a blood clot in your lung or deep within a vein of your leg or pelvis.

What is the cut off for D-dimer? ›

D-dimer measurement is a very important step in VTE diagnosis, as it allows clinicians to rule out the disease in around 30% of outpatients with suspected DVT or PE. However, the test is less useful in elderly patients (as D-dimer tests at a cutoff of 500 ng/mL are rarely truly negative).

What is the D-dimer value for pulmonary embolism? ›

Patients with D-dimer levels over 1.96 mg/L (4 times of the normal level) have a significant risk for PE. In patients with SGS ≥ 3, the D-dimer cutoff point concentration for PE risk moves to the levels of 2.2 mg/L.

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