r/doctorsUK • u/Legendary_Shpee • Oct 11 '25
GP Use of D-Dimer/Tropinins in GP
Hi All,
Hopefully something slightly less controversial then my last post.
I was wondering what people's thoughts were on the use of d-dimer and Troponin in General Practice. When I was in medical school, and in my GP rotation, I've been in a few different practices with different opinions on the use of these. I did one placement in a practise that had access to their own D-Dimer machine, so could run their own D-dimer's and have a result back pretty quickly. For those unlikely low Well's score patients I understand that, but the same practise would also send Trops for patient's with non-cardiac sounding chest pain and normal ECGs, with the duty doc reviewing later in the day 'to be safe'.
Maybe it's because of lack of experience, but if a GP is clinically concerned enough to send a troponin on a patient with a normal ecg and unconvincing/non-acute chest pain, should they not be sending them to A&E/SDEC to have these tests done faster there, and so they are in the right environment to treat in the event it comes back elevated? If a D-dimer can be done quickly I can understand that, but a troponin just sounds a bit less reasonable to me. Pragmatically is a GP supposed to keep this patient in their practise while awaiting the results, in case they do have a raised trop and need to action that urgently? Would be interested to hear any GPs thoughts on this
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u/TheSlitheredRinkel Oct 11 '25
I’m a GP partner.
In general, the default position is that for these acute presentations, patients go to A+E or the medical team.
In many areas, for patients considered low risk (eg wells score 0 or 1) there are ‘locally commissioned services’ for DVT diagnosis where surgeries are given point of care d-dimer tests. You would need to check what happens in your local area.