53 /Y female with C/O swelling of both lower limbs ,abdominal distension , shortness of breath ,decreased urine output since 10 days HOPI: B/L pedal edema since 10 days upto thighs ,pitting type, progressive initially upto ankle now progressed upto thighs associated with abdominal distension and decreased urine output,h/o burning micturition +, C/o sob since 10 days,progressed from grade 2 to grade 4, orthopnea +, No h/o fever, cough, chest pain ,headache,,giddiness, palpitations, sweating Pt is chronic alcoholic since 15 yrs stopped since 10 days,non smoker,h/o tightness of abdomen PAST HISTORY Not a k/c/o htn,dm bronchial asthma, epilepsy, cad,thyroid disorders H/O urinary stenting done 10 yrs back PERSONAL HISTORY Auto driver by occupation, appetite is normal, bowel movements regular, decreased urine output since 10 days ,regular alcoholic since 15 yrs GENERAL EXAMINATION No signs of pallor, icterus, cyanosis , clubbing, lympadenopaty Pedal edema + upto knee Temperature