Overview of the D-dimer Test: Uses, preparation and risks

Team AckoMay 23, 2024

Clotting is a crucial and necessary process that prevents excessive loss of blood when you are wounded. In case of an injury to a blood vessel or tissue in your body causing bleeding, your body initiates a process known as hemostasis to develop a clot to control blood loss and ultimately stop the bleeding. 

Throughout the hemostasis process, your body produces fibres of a protein known as fibrin, which intertwines to create a net. This net, along with a platelet, assists in securing the blood clot in its place until the injury is healed. These blood clots might show up as scabs on your skin or bruises beneath your skin. 

After your injury has recovered and your body no longer requires the blood clot, your body generates an enzyme called plasmin to dissolve the clot into small fragments for removal. These fragments are referred to as fibrin degradation products. D-dimer is one of those. 

If you suffer from a blood clotting disorder, blood clots can form without any injury, and they fail to dissolve when necessary. Therefore, your body's blood clotting process stops functioning properly. Blood clotting disorders can be severe and life-threatening.

When doctors suspect internal blood clots, they prescribe a D-dimer blood test. It measures the D-dimer levels in your bloodstream and checks for or monitors blood clotting problems. Read this article to understand everything about the D-dimer Test.

Contents

• What is a D-dimer Test?
• What is it used for?
  • 1. Pulmonary embolism (PE)
  • 2. Deep Vein Thrombosis (DVT or venous thrombosis)
  • 3. Disseminated intravascular coagulation
  • 4. Stroke
• Why do I need this test?
  • Signs of DVT
  • Signs of PE
  • Signs of DIC
  • Signs of stroke
• D-dimer test for covid
• How is a D-dimer Test done?
• What do the results mean?
• When can the test give inaccurate results?
• Is there anything else I should know about a D-dimer Test?
• What are the risks of the D-dimer Test?
• Frequently asked questions

What is a D-dimer Test?

A D-dimer Test is one of the types of blood tests that help identify blood clotting problems. D-dimer is a kind of protein fragment present in the blood after the blood clot dissolves in the body. In general, it is either undetectable in the blood or only detectable when your body produces and dissolves blood clots.

What is it used for?

This test is used to determine which type of blood clotting disorder an individual has. There are different types of blood clotting problems, which are as follows.

1. Pulmonary embolism (PE)

It is the blood clot in the artery in the lungs, which occurs when a clot from another part of your body travels and becomes lodged in the blood vessel. This blood clotting condition leads to issues in the exchange of flow of gas and blood. As a result, it can cause a life-threatening issue.

2. Deep Vein Thrombosis (DVT or venous thrombosis)

It forms deep inside a vein where it can partially or completely block the flow. This type of blood clotting disorder mostly occurs in the lower leg, pelvis, and thigh. It can even form in the brain, arms, liver, and other parts of the body.

3. Disseminated intravascular coagulation

This condition leads to the formation of several blood clots throughout the body. It can cause multiple organ dysfunction and serious complications. 

4. Stroke

It is also known as CVA, a Cerebrovascular Accident, and it occurs when the blood supply in the brain is blocked or burst. It is a medical emergency that requires immediate treatment.

Why do I need this test?

Your doctor will order this test if they see any warning symptoms of blood clotting problems. Mentioned below is the list of signs of each condition. 

Signs of DVT

• Swelling in the leg or arm

• Throbbing or cramping pain in one leg

• Leg soreness

• Warmth in the swollen area

• Redness on legs

Signs of PE

• Sharp chest pain

• Fainting

• Rapid irregular heartbeat

• Sweating

• Coughing (sometimes with bloody phlegm)

• Sudden shortness of breath

• Back pain

• Fever

• Anxiety

• Clammy skin

Signs of DIC

• Severe stomach pain and muscle pain

• Bleeding gums

• Easy bruising

• Dizziness

• Blood in urine

• Swelling and pain in lower legs

• Shortness of breath 

• Headaches 

• Bloody stools

Signs of stroke

• Sudden and severe headache

• Difficulty speaking

• Sudden numbness or paralysis in the face, arm, or leg

• Sudden dizziness 

• Loss of coordination

• Loss of vision

• Sudden loss of balance

• Confusion or trouble understanding other people 

D-dimer test for covid

People with some mutations of the Covid-19 virus get negative RT-PCR results despite showing symptoms. Therefore, healthcare professionals need to perform further investigations. The D-dimer test in Corona has become common because many patients get blood clots. 

The test indicates the existence of blood clots in the body during the progression of COVID-19. Numerous clots accumulate in the body, particularly in the lungs, resulting in difficulty breathing. 

Clotting disrupts the normal flow of blood, prompting the body to attempt to dissolve these clots. The presence of D-dimer can be detected for a period of up to eight hours following its formation, after which time the kidneys eliminate it from the body.

An increased level of D dimer in the body indicates a significant presence of blood clots, which can be a concerning indicator when dealing with COVID. Therefore, healthcare professionals utilize D-Dimer testing to evaluate the seriousness of the COVID-19 infection. 

The D-dimer test in COVID-19 also helps predict if the patient will require oxygen in the future. As the D-dimer levels rise, so does the number of clots in the lungs, increasing the likelihood that oxygen will be necessary.

How is a D-dimer Test done?

The process of the D-dimer Test is simple, and you do not need to do anything to prepare. 

• It is a blood test, and you will be asked to sit on a chair or lie on a medical bed. 

• Your doctor will look for an easily accessible vein in the inner part of your arm. 

• After locating the vein, they will disinfect that particular area, and then a thin, small needle will be inserted into the vein from which it will draw the blood. 

• The blood will be collected in a small test tube, and they will get the needle off your vein. 

• They will quickly place a cotton ball on the area to stop the bleeding. 

• After a few seconds, they will place a bandage over the area, and the process will be done. It will usually take less than 5 minutes. 

• The cost of this test often varies from city to city. 

• However, the average cost of a D-dimer blood test is around Rs. 1,000 in India. 

You may get the report within 24 to 48 hours, as the test is usually used in emergency rooms.

What do the results mean?

This test helps the doctor determine if you have any blood clotting disorders such as DVT and PE. The test depicts the level of D-dimer in your blood: low, normal, or high level. 

If the report shows low or negative, then it means you probably do not have any blood clotting condition.

When the result is positive or high, then your doctor will likely order more tests before commencing the treatment.

The test report may vary from lab to lab because different labs may do the test differently. In general, the normal D-dimer range is 220 to 500 ng/mL.

The D-dimer Test cannot confirm if you have DVT or PE. Also, it cannot show the area or the type of clotting disorder you may have.

 Well, there can be other reasons why you have a high or positive D-dimer report, which are as follows. 

• Heart diseases

• Infection

• Liver disease

• Recent surgeries 

• Pregnancy

• Some cancers

When can the test give inaccurate results?

While D-dimer tests generally provide reliable results, there may be instances where they're not fully accurate. This can be influenced by differences in testing procedures, medications taken, or specific health issues that exist. In rare cases, you might get the following results:

• A false positive: It happens when there are increased D-dimer levels in your bloodstream but no presence of a blood clot. Various situations can cause D-dimer levels to rise without a clot, such as being pregnant, recent surgery or infection, rheumatoid arthritis, lupus, and sickle cell disease. Some medications with estrogen can also result in incorrect positives, like hormone replacement therapy or oral contraceptives.

• A false negative: It happens when there is a blood clot, but the results of the D-dimer test do not indicate that. This can occur when the test is done while a new clot is developing or if you are on blood thinning medications.

If the healthcare provider thinks that the test results are inaccurate, they will recommend another D-dimer test. In some cases, they might recommend other diagnostic tests to look for blood clots in the body. 

Is there anything else I should know about a D-dimer Test?

By now, you already know that low or negative results show that you do not have any blood clotting problems. Also, having a high or abnormal or positive result does not necessarily mean you have any DVT or PE. So, to diagnose your problem, your doctor will order one or more imaging tests, which are as follows. 

• CT angiography: In this test, an angiogram uses an X-ray machine to develop images of the heart and blood vessels. 

• Doppler ultrasound: It is a non-invasive test that uses sound waves (ultrasound) to listen to your blood flow through blood vessels.

• Ventilation-perfusion (V/Q) scan: This type of scan uses radioactive material to determine how well air and blood flow in the lungs.

What are the risks of the D-dimer Test?

This type of test is the standard form of a blood test, and it does not involve any risk. Just like mentioned above, a doctor, nurse, or phlebotomist will simply draw your blood for the test by using venipuncture. You may feel slight pain, bruising, or soreness at the site where the needle was inserted. But there is nothing serious to worry about. These symptoms go away quickly. 

Frequently asked questions

Here is the list of the common questions and answers related to the D-dimer Test and blood clotting.

How to prepare for a D-dimer Test?

The test is simple, and you do not need any special preparation before taking this test.

What does it mean if your D-dimer is high?

High levels of D-dimer in your blood can be an indication of a blood clotting problem. However, your doctor would order more tests to confirm the diagnosis.

What are the primary signs of a blood clot?

Some of the common symptoms of blood clotting are as follows.

Sharp chest pain

Coughing (sometimes with bloody phlegm)

Swelling in an arm or leg

Redness or warmth in a leg or arm

Cramping or throbbing pain

Sudden breathlessness 

Can blood clots go away?

Your body often dissolves the blood clots that occur as a result of an injury. Sometimes these clots are formed inside vessels without any obvious reasons, and they do not dissolve naturally. At this time, accurate diagnoses and timely treatment is needed. Otherwise, the clots may cause serious consequences.

Can I control my D-dimer naturally?

You should consult your doctor if your D-dimer levels are high. Having abnormal levels can be dangerous and require prompt treatment. 

Who is prone to blood clots?

The following factors make one prone to blood clots.

Pregnant ladies

Those who have undergone surgery

Having a family history of blood clots

Some types of cancers 

How to prepare for a D-dimer Test?

The test is simple, and you do not need any special preparation before taking this test.

What does it mean if your D-dimer is high?

High levels of D-dimer in your blood can be an indication of a blood clotting problem. However, your doctor would order more tests to confirm the diagnosis.

What are the primary signs of a blood clot?

Some of the common symptoms of blood clotting are as follows.

Sharp chest pain

Coughing (sometimes with bloody phlegm)

Swelling in an arm or leg

Redness or warmth in a leg or arm

Cramping or throbbing pain

Sudden breathlessness 

Can blood clots go away?

Your body often dissolves the blood clots that occur as a result of an injury. Sometimes these clots are formed inside vessels without any obvious reasons, and they do not dissolve naturally. At this time, accurate diagnoses and timely treatment is needed. Otherwise, the clots may cause serious consequences.

Can I control my D-dimer naturally?

You should consult your doctor if your D-dimer levels are high. Having abnormal levels can be dangerous and require prompt treatment. 

Who is prone to blood clots?

The following factors make one prone to blood clots.

Pregnant ladies

Those who have undergone surgery

Having a family history of blood clots

Some types of cancers

What level of D-dimer is dangerous?

A positive D-dimer test means there’s 0.50 mg/l or a higher amount of FEU in the bloodstream. It can be dangerous because it hints at the presence of blood clots. 

 

References

• https://medlineplus.gov/ency/article/000573.htm

• https://www.cdc.gov/stroke/signs_symptoms.htm

• https://www.ncbi.nlm.nih.gov/books/NBK564428/

• https://www.cdc.gov/ncbddd/dvt/features/blood-clot-risk.html

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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