Ahmed Mohsen: How Should D-Dimer Be Interpreted in Pregnancy?
Ahmed Mohsen, Associated Professor of Cardiology at Cairo University, shared a post on LinkedIn:
“Cardiology Challenge!
A pregnant lady presents with unexplained dyspnea… You suspect Pulmonary Embolism (PE)
What is the most important test to request first?
Check the ideal answer from my book: Tips and Tricks in Cardiology
Follow the Pregnancy-Adapted YEARS Algorithm
Many physicians immediately think of CTPA
Not always!
If YEARS criteria are present, the first step is:
Lower Limb Venous Duplex Ultrasound
Why?
- If DVT is confirmed, anticoagulation should be started immediately
- No need to expose the mother or fetus to additional radiation
- No need to prove PE with further imaging in most cases
Also remember:
D-dimer can still be useful during pregnancy —but it should be interpreted using the Pregnancy-Adapted YEARS algorithm, not the conventional cut-off.
Key Tip:
A positive lower limb venous duplex in a pregnant patient with suspected PE may save the patient from unnecessary CTPA and radiation exposure.
Tip from my book:
Tips and Tricks in Cardiology
Practical. Guideline-based. Board-exam friendly.”
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