Korotkoff
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36-years old woman came to ER with the complaint of shortness of breath. Her vital signs: BP = 110/70mmHg, PR = 120/min, Temp = afebrile, RR =22/min.
Negative result of which of the following tests would exclude venous thromboembolism?
a) Echocardiography
b) Venous Ultrasound
c) ECG
d) Plasma D-dimer
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| hero
Forum Elite
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d- dimer
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| cool doctor
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| Ivonne
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At the present time, D-dimer alone is not sensitive or specific enough to rule out or rule in the diagnosis of PE. Its adoption in many emergency departments has increased the number of patients undergoing some evaluation for PE but has not led to any significant change in the frequency with which the diagnosis is confirmed. A patient with signs or symptoms suggestive of DVT and PE may have a positive or a negative D-dimer and still may have a final diagnosis discordant with the D-dimer and/or discordant with the clinical impression. A negative ultrasound scan does not rule out DVT, because many DVTs occur in areas that are inaccessible to ultrasonic examination. Before an ultrasound scan can be considered negative, the entire deep venous system must be interrogated using centimeter-by-centimeter compression testing of every vessel.
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| Vietnamese
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D
Although positive result of D-Dimer is not significantly meaningful for PE but negative result of D-Dimer is meaningful to rule out PE other than ECG, Venous sonogram and echocardiogram.
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| farnsworth
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D
see: http://www.aafp.org/afp/20071015/practice.html#p1
and a recent article on computed tomographic pulmonary angiography for diagnosis of PE: http://jama.ama-assn.org/cgi/content/full/298/23/...
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| Korotkoff
Forum Senior
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Yup. D
Plasma D-dimer has 95 - 97% sensitivity and 45% specificity
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