When you have symptoms of a thrombotic episode or a condition that causes acute and/or chronic inappropriate blood clot formation, such as deep vein thrombosis (DVT), pulmonary embolism (PE), or disseminated intravascular coagulation (DIC), and to monitor the progress and treatment of DIC and excessive clotting conditions
A D-dimer test may be ordered when someone has symptoms of deep vein thrombosis, such as:
Leg pain or tenderness, usually in one leg
Leg swelling, edema
Discoloration of the leg
It may be ordered when someone has symptoms of pulmonary embolism such as:
Sudden shortness of breath, labored breathing
Coughing, hemoptysis (blood present in sputum)
Lung-related chest pain
Rapid heart rate
Clotting is more likely to happen in people who are older, are obese or overweight or have conditions — such as cancer or autoimmune disorders such as lupus. It’s also more likely in people whose blood is thicker than normal because too many blood cells are made by bone marrow. Genetic causes of excessive blood clotting are also important. These occur when there are changes in the genetic code of some proteins needed for clotting or proteins that work to naturally dissolve blood clots in the body.
Major general surgery
Major orthopedic surgery
Lower-extremity paralysis due to spinal cord injury
Fracture of the pelvis, hip or long bones
Chronic obstructive pulmonary disease
Cancer — all cancers increase the risk, especially if cancer has spread widely, and if it is cancer of the lung, brain, lymphoma, gynecologic system (like ovary or uterus), or gastrointestinal tract (like pancreas or stomach). In patients with cancer, chemotherapy and surgery for cancer further increase the risk.
Prior VTE— Patients with a previous episode of VTE have a high chance of recurrence.
Age— Patients older than 40 years are at higher risk, and that risk doubles with each subsequent decade.
Obesity – people with obesity have 2 times the risk of VTE as people with normal weight, and the higher the weight, the higher the risk.
Immobility— Prolonged immobility combined with other major risk factors increases the likelihood of VTE (truck drivers and people who travel a lot).
Oral Contraceptives or estrogen treatment for menopause symptoms.
Family history of VTE— especially if this is in a first-degree relative (parent, sibling, child).
Genetic blood conditions that affect clotting.
Women who are pregnant, or have just had a baby are at greater risk of developing a blood clot. The risk is greater in the presence of the following other factors:
A genetic predisposition to VTE or a family history of VTE (especially in a first-degree relative-parent, sibling)
Immobilization, such as bed rest and long distance travel
Older maternal age
Other medical illness during pregnancy, like cancer, serious infection or toxemia/pre-eclampsia