54 geetha

January 17 2022 58 year old male, labourer by occupation, came to the OPD with the chief complaints of Shortness of breath since 30 days, worsened 1 day back, chest pain since 30 days ,facial puffiness since 30 days History of Presenting illness -  Patient was apparently asymptomatic 4 years ago 4 years ago - pt complained of giddiness, went to a local hospital and was diagnosed as Hypertensive, on regular medication since then T. Nicardia 10mg, T. Arkamine 0.1mg sos 2 years back Pt developed B/L pedal edema, progressed gradually to knees, diagnosed with renal failure and initiated dialysis weekly twice Left upper limb swelling, gradually progressing to current size, since 4 months . Also developed rt upper limb swelling since 4 days.  Swelling in the left chest region, gradually progressing to current size, since 4 months Back pain since 2 months, subsided on medication (T. Ultracet) 30 days back - developed Shortness of breath , Grade II-III progressed to Grade IV since 30 days along