CME CASE PRESENTATION
49 yr male known diabetic came with the complaints of Breathlessness since 1 week B/l swelling of feet since 1 week Cough since 1 week HISTORY OF PRESENT ILLNESS Patient was apparently asymptomatic 1 week ago then he developed shortness of breath class II of NYHA insidious onset , gradually progressive a/w profuse sweating , a/w paroxysmal nocturnal dyspnea,orthopnea No diurnal variations *No h/o chest pain , palpitations ,syncopal attacks Cough with sputum of mucoid consistency,non blood tinged,non foul smelling No h/o ,fever,sore throat,hoarseness of voice No h/o nocturnal cough B/swelling of lower limbs extending upto knee insidious onset pittting type No h/o Decreased urine output,burning micturition No h/o long standing hours *No h/o abdominal distension ,facial puffiness HISTORY OF PAST ILLNESS No h/o similar complaints in the past Known case of TYPE II DIABETES MELLITUS since 8 yrs Known case of epilepsy with last episode 40yrs back Not a k/c/o HTN ,CVA,CAD ,TB ,THY
