My d dimer is elevated (500) 34 yo no history besides kidney stones and old ulcer, have chest pain and sob, & doe, ct clean for pe, ultrasound clean for clots, not pregnant, no infection. other lab work (cbc, bmp, lfp, coag)normal. would could it be?

Your symptoms may indicate a PE, and another imaging screening may be considered, and EKG 12 lead may be associated with abnormalities. Consider cardiac conditions and a Cardiology appointment. There are other causes of an elevated D Dimer test and PE should be ruled out.

D-dimer can be elevated due to many causes, including inflammation. A D-dimer assays is more useful for excluding clots than making a positive diagnosis. You need to discuss it with the doctor who ordered the test. Wish you good health!