D-Dimer, Quantitative

Description: The D-Dimer Quantitative test is used to evaluate fibrinolytic activation and intravascular thrombosis.

Also Known As: Fragment D-Dimer Test, Fibrin Degradation Fragment Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is a D-Dimer test ordered?

When a patient presents to the emergency room with signs of a dangerous disease, D-dimer testing is frequently prescribed.

When a patient exhibits signs of pulmonary embolism or deep vein thrombosis, a D-dimer test may be prescribed.

When a doctor suspects that another condition other than deep vein thrombosis or pulmonary embolism is the likely cause of symptoms, D-dimer is particularly helpful. It is a rapid, non-invasive method that can help rule out excessive or irregular coagulation. However, it should not be taken if a clinical examination indicates that there is a high likelihood of pulmonary embolism.

To help in the diagnosis of disseminated intravascular coagulation, a D-dimer test coupled with a PT, PTT, fibrinogen, and platelet count may be prescribed for someone who exhibits symptoms like bleeding gums, nausea, vomiting, intense muscle and abdominal pain, seizures, and decreased urine output. When someone is receiving therapy for DIC, D-dimer orders may also be placed periodically to help track the condition's development.

What does a D-Dimer blood test check for?

One of the protein fragments created when a blood clot dissolves in the body is called D-dimer. Normally, it goes unnoticed until the body is generating and dissolving blood clots. Its blood level may then increase as a result. D-dimer in the blood is found using this test.

The body starts a process known as hemostasis when a blood vessel or tissue is injured and starts bleeding in order to form a blood clot that will eventually stop the bleeding. A fibrin net is created by the crosslinking of fibrin threads, which are produced as a result of this process. Platelets and that net work together to contain the blood clot that is forming until the wound has healed.

The body utilizes an enzyme called plasmin to break the thrombus into small pieces so that it can be eliminated after the area has had time to heal and the clot is no longer required. Known as fibrin degradation products, the fragments of the breaking down fibrin in the clot are made up of different sized bits of crosslinked fibrin. D-dimer, one of the last byproducts of fibrin breakdown, can be detected in blood samples and quantified. When blood clots are formed and broken down significantly in the body, the level of D-dimer in the blood may increase.

The D-dimer test's strength is that it can be utilized in a hospital emergency room setting to assess the likelihood of a clot's existence for a person who is at low or moderate risk for blood clotting and/or thrombotic embolism. If the D-dimer test is negative, a thrombus is extremely unlikely to be present. A positive D-dimer test, however, cannot indicate the presence or absence of a clot. It suggests that additional testing is necessary.

Unwanted blood clot formation is related to a number of variables and diseases. Deep vein thrombosis, which causes clots to form in the body's deep veins, most usually in the legs, is one of the most frequent. These clots have the potential to become very large and obstruct blood flow to the legs, resulting in swelling, discomfort, and tissue damage. It is possible for a fragment of the clot to separate and spread to different bodily regions. This "embolus" may become lodged in the lungs and result in pulmonary embolism. Up to 300,000 deaths in the U.S. are attributed to pulmonary embolisms brought on by DVT each year.

Clots can develop in different places, though they most frequently do so in the veins of the legs. Any of these places may benefit from D-dimer measurements to aid in the discovery of clots. For instance, myocardial infarction is brought on by clots in the coronary arteries. When the heart is pounding irregularly or when the valves are damaged, clots are more likely to form on the lining of the heart or its valves. Additionally, clots can develop in big arteries due to atherosclerosis-related constriction and damage. Such clot fragments may break off and create an embolus, which stops an artery in another organ, such the kidneys or the brain.

In addition to other tests, D-dimer measurements may be requested to assist in the diagnosis of disseminated intravascular coagulation. DIC is a condition when the body's clotting factors are activated and subsequently depleted. This causes multiple small blood clots to form while also making the victim susceptible to heavy bleeding. It is a challenging, occasionally fatal illness that can develop following a number of medical procedures, infections, toxic snake bites, liver diseases, and postpartum conditions. While the underlying ailment gets better, measures are taken to support the affected person. In DIC, the D-dimer level is frequently very high.

Lab tests often ordered with a D-Dimer test:

• PT and INR

• PTT

• Fibrinogen Activity

• Platelet Count

• Complete Blood Count (CBC)

Conditions where a D-Dimer test is recommended:

• Excessive Clotting

• Disseminated Intravascular Coagulation

• Pulmonary Embolism

• Deep Vein Thrombosis

How does my health care provider use a D-Dimer test?

D-dimer tests are used to assist in excluding the possibility of an unexpected blood clot.

This test can assist establish whether more testing is required to evaluate diseases and conditions that lead to hypercoagulability, or a propensity to clot unnecessarily.

A D-dimer level can be used to monitor DIC therapy effectiveness and aid in the diagnosis of disseminated intravascular coagulation.

What do my D-Dimer test results mean?

The likelihood that a person examined does not have an acute ailment or disease that causes aberrant clot formation and breakdown increases if the D-dimer result is normal or negative. The majority of medical professionals concur that a negative D-dimer test is most reliable and helpful when it is performed on individuals who are thought to have a low to moderate risk of thrombosis. The test is employed to assist in excluding coagulation as the root of the symptoms.

A high level of fibrin breakdown products may be present if the D-dimer test is positive. It does not specify the location or origin, but rather suggests that there may be major blood clot development and disintegration in the body. For instance, it might be caused by disseminated intravascular coagulation or venous thromboembolism. In DIC, the D-dimer level is frequently very high.

However, because a number of different causes might result in a raised level, an elevated D-dimer does not always mean that a clot is present. Elevated amounts may be present in diseases or conditions where fibrin is not regularly eliminated, such as liver illness, or diseases or conditions where fibrin is not normally cleared, such as recent surgery, trauma, infection, heart attack, and several malignancies. D-dimer is therefore rarely used to exclude VTE in hospitalized patients.

During pregnancy, fibrin is also produced and degraded, which could cause a rise in D-dimer levels. The D-dimer test, combined with a PT, PTT, fibrinogen, and platelet count, may be utilized, however, to help detect DIC in a woman who is pregnant or who is soon after giving birth. Her D-dimer level will be exceedingly high if the woman has DIC.

D-dimer is advised as an additional test. The D-dimer test should only be performed to rule out deep vein thrombosis and not to confirm a diagnosis because it is a sensitive test but has low specificity. When the clinical likelihood of pulmonary embolism is high, it shouldn't be utilized to treat the condition. Follow-up and additional testing may be necessary for both elevated and normal D-dimer levels. Further investigation using diagnostic imaging is necessary for patients with positive D-dimer tests and those who have a moderate to high risk for DVT.

When used to track the effectiveness of DIC treatment, decreasing levels signify success while rising levels could mean treatment failure.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.