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A 65 yr old female presented with Pedal Edema and SOB

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65 year old female patient resident of nalgonda came to the opd with chief complaints of • shortness of breath since 1 week • Pedal edema since 3 months  • back pain since 1 week  HISTORY OF PRESENT ILLNESS Patient was apparently asymptomatic 4 years back then she developed flank pain, leg pain and Pedal edema bilaterally for which she consulted local practictioner and then was on medication. Since it was not subsiding 5 months back she went to nalgonda hospital and was diagnosed with kidney failure . Now 1 week back she came with complaints of SOB grade 2-3 ,progressive ,aggravated on walking and relieved on rest. PAST HISTORY K/C/O hypertension since 10 years Not a K/C/O DM, TB, Asthma, epilepsy.  DAILY ROUTINE  She was a farmer ,daily wage laborer by occupation but she stopped working since 2 years because of back pain and Pedal edema.  Wakes up at 4Am Cooking and household activities  Breakfast at 9am Talking to neighbours  Lunch at 12am Sleep and ...