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[Negative D-dimers and peripheral pulmonary embolism].
N Mansencal1, T Joseph, A Vieillard-Baron
1Service de cardiologie, Assistance Publique-Hôpitaux de Paris, hôpital Ambroise Paré, Boulogne. nicolas.mansencal@apr.ap-hop-paris.fr
Archives Des Maladies Du Coeur Et Des Vaisseaux
|July 14, 2004
Summary
Negative D-dimer tests can occur in patients with pulmonary embolism (PE). Distal PE cases with negative D-dimers often present with chest pain and require further investigation.
Area of Science:
- Medical diagnostics
- Biochemistry
Context:
- D-dimer testing is a valuable tool for diagnosing pulmonary embolism (PE).
- Rare instances of PE with negative D-dimer results have been reported.
- Understanding these cases is crucial for accurate PE diagnosis.
Purpose:
- To investigate patients with PE and negative D-dimer results.
- To compare these patients with those who have PE and elevated D-dimers.
- To analyze clinical and diagnostic findings in relation to D-dimer levels.
Summary:
- A study of 150 PE patients found D-dimer sensitivity to be 96%.
- Patients with negative D-dimers were more likely to report chest pain.
- Distal emboli, lower Miller index, and reduced ultrasound diagnostic value were observed in the negative D-dimer group.
Impact:
- D-dimer testing may be non-diagnostic for distal pulmonary embolism.
- A strong clinical suspicion of PE warrants further investigation despite negative D-dimers.
- This research refines diagnostic strategies for pulmonary embolism.