50 year old female patient presented to opd with a chief complaint of shortness of breath and bipedal edema since 15 days

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50 year old female patient labour by occupation resident of kodada presented to opd with a chief complaint of shortness of breath and bipedal edema since 15 days 

HISTORY OF PRESENT ILLNESS
She was asymptomatic 1 year back and later she developed bipedal edema which was recurrent even on medication prescribed by local doctor 

Since 15 days she complains of bipedal edema  which is geting relieved while resting and agravating while walking 
 
She  complains of shortness of breath while walking since 15 days and relieved while resting 

She complains of loss of appetite and vomting sensation after eating some quantity of food

She complains of facial puffiness since 15 days

PAST HISTORY 
BP since 6 months 
No diabetes 

FAMILY HISTORY 
Not significant 

PERSONAL HISTORY 
Mixed diet 1 year back 
Used to drink 7 litres of water daily 1 year back

GENERAL EXAMINATION
No clubbing 
No cyanosis 
Pallor is seen 
No icterus 

Percussion of abdomen 
No fluid present 
No palpable mass
Liver not palpable 

Vitals 
Temp 98.4
Respiration 18 cycles per min
Bp 160/90
Pulse 82 beats /min 

Respiratory system 
Bilateral breath sounds are not heard 
No wheezing sounds 
No crepitations 

CVS
S1 and S2 are heard 
JVP is seen

CNS 
conscious , coperative ,coherent 
Reflexes are normal 
No speach problems 
Gait was normal , erect 

INVESTIGATIONS


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