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45 year old male with history of Pedal oedema and Shortness of breath

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CASE :  45 year old male , lorry driver by profession , resident of Nalgonda came with chief complaints of Shortness of breath since 4 months HOPI : Patient daily routine includes , he used to drive lorry across the states - work for 5-6 days a week from the age of 20 yrs. Until 4 months back he was living happily with his family but 4 months back everything started to go wrong when he was not able to do his work of earning. He was apparently asymptomatic 4 months ago then he developed shortness of breath grade - 3 insidious in onset , progressive ,relieved on taking medication and rest . associated with orthopnea. He was taken to a local hospital and dialysis was initiated. History of Pedal oedema after a week , pitting type upto knees was seen . Dialysis was done since 4 months , twice weekly History of Dry cough since 15 days , sudden in onset 7-10 episodes in a day and each episode consisting of 8-10 bouts of cough . Oliguria since 1 week No history of fever, burning micturition