Hey docs,
My mom has been having problems with arrhythmias for the past couple of months. 2 months ago she had elevated D-dimer levels at about 1300μg/l, she had her lungs screened and was told they were fine and her other blood results were good. D-dimer levels went down and she has been feeling good. She was told by her cardiologist that it was probably the result of a viral infection, tho she had no symptoms of the sort.
Yesterday she had a slower than normal heart rate at 52bpm, and felt unwell for a few hours, and after getting a blood test today D-dimer levels are elevated again at about 1200μg/l. She is feeling completely fine now, and will be wearing a holter monitor for a day, and that’s everything that’s being done for now. I tried researching the literature on elevated D-Dimer levels and I see that it could be linked with serious problems, but I’m having doubts that we’re doing everything we can. Do you have any advice on what should be done going forward?
Thanks in advance
“Arrhythmia” is an extremely broad, vague term – so it’s not clear what specific heart rhythm issues are of concern here. I would need more information, EKGs, etc., to provide more insight – although this is the exact sort of thing her cardiologist would be doing as well.
I also have no idea why her doctors are continuing to monitor her D-dimer levels on an ongoing basis here. It is not part of the routine evaluation for this sort of complaint at all, unless there is a suspicion for pulmonary embolism (which is what I suspect you meant by “had her lungs screened”). There is no way to interpret or draw conclusions from this sort of a D-dimer “trend” in this specific context.
It would be worth pursuing the Holter monitoring to see whether there are actually any real abnormal heart rhythms at all, and if so then the specific rhythm disturbance can guide further evaluation and management. I would also typically check a thyroid-stimulating hormone (TSH) level here. Beyond this, I can’t really comment further based on the limited information here – but would reiterate that the D-dimer measurements are most likely irrelevant.
Thanks for the response Austin, I’m sorry if I’m not being clear enough. 2 months ago she went through the Holter monitoring as well, and it showed premature heartbeats during certain periods of the day, which is what I meant by arrhythmias and suspicion for pulmonary embolism was indeed the reason for the screening.
We will see what the results of the Holter monitoring will be like and carry on from there.
Also since she does a lot of dancing, she was advised to refrain from vigorous physical activity, which after a long time of following Barbell Medicine always doesn’t sit quite right with me. Can you give your opinions on this or do you think it’s unwise given the lack of information on my part?
I see. Based on the information you’ve provided here, I see no reason to recommend restricting activity, or to continue checking D-dimer levels.
This is based on incomplete clinical information, so keep in mind that this cannot be an official medical recommendation via a forum, of course.
I understand. Thank you very much, I really appreciate it and all of the work you do at BBM.