Normal D-dimer ved dyb venøs trombose i en overekstremitet hos to patienter med pacemaker

Danish guidelines recommend the use of D-dimer to exclude deep venous thrombosis (DVT) in the lower extremities. However, guidelines are lacking for DVT in the upper extremities. We describe two young women with transvenous pacemaker electrodes and symptomatic DVT in related veins. Despite a normal D-dimer, DVT was verified by colour Doppler ultrasound in both cases. The guidelines of American College of Chest Physicians recommend initial evaluation using colour Doppler ultrasound as front-line examination. Accordingly, we suggest a similar revision of Danish guidelines incorporating upper extremity DVT as well.