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2013 Feb;75(2):144-53

A simple way to think about it is in two phases

10 Changes in cardiac and hemostatic biomarkers (including D-dimer) after strenuous endurance exercise can mimic pulmonary embolism and myocardial injury in individuals who are not actually at risk

Just a better way.

For example, if someone who was earmarked for the study had a pre-study screening scan that showed they had an arthritic toe joint for example, or a plantar plate tear etc