Pregabalin is a commonly prescribed medicine for the treatment of diabetic neuropathy. The adverse effect of this drug on long-term use remains unknown. This is a case of a 47-year-old female who presented to hospital with a history of shortness of breath. She was a known case of with diabetic neuropathy receiving pregabalin 75 mg orally once a day. The patient had a heart rate of 112 beats/minute, blood pressure of 102/52 mm Hg, respiratory rate of 28/minute, peripheral oxygenation saturation of 88% on room air, and D-dimer of 2.29 mg/L. Transthoracic echocardiography [two-dimensional (2D)] showed paradoxical motion of intraventricular septum (IVS), elevation in pulmonary artery systolic pressure (50 mm Hg), mild right atrial/right ventricular (RA/RV) dilatation and normal left ventricular (LV) systolic function. Chest X-ray suggestive of left middle zone haziness. Computed tomography of pulmonary angiogram (CTPA) showed a thrombus at the left main pulmonary artery. The other risk factors for pulmonary embolism (PE) were absent. Hence, a diagnosis of acute pulmonary thromboembolism (PTE) secondary to drug-induced (pregabalin) was made and managed with tenecteplase, heparin, and later rivaroxaban. The patient improved and was discharged home in hemodynamically stable condition. This case report highlights a case of pregabalin-associated PTE. Early diagnosis and management can reduce morbidity and mortality.
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