62 year old woman with breathlessness

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A 60 year old woman presented with the complaints of 
Dyspnea at rest since 15 days
Left lower limb swelling upto knee since 10 days
Reduced urine output since 10 days
A 60 year old woman who used to work as a farmer 3 years back, mother of 5 children (3 daughters and 2 sons - 1 son expired, patients attendant reluctant to discuss the cause) presented to the casualty with the complains of dyspnea on exertion since 1 year. 1 year back she visited Osmania hospital for these complaints after which she has been put on medications which she has been using on and off (not documented). Since the past 4 months she has been experiencing dyspnea at rest on and off, whenever she experiences dyspnea she visits a hospital, takes medication and then stops taking them.
Since the past 15 days she has been experiencing dyspnea at rest and 10 days back she has had a trauma to her right 2nd toe after which she developed left lower limb swelling along with reduced urine output. She was taken to a local hospital where she was told that she developed left lower limb cellulitis.
Pallor+
PR - 120bpm
BP - 120/60mmhg
RR - 27cpm
Spo2 - 96% on Room Air 
Cvs - 
JVP raised
Parasternal heave +
Palpable P2
Visible apex beat
Apex beat in 6th ICS , 1cm lateral to MCL
Epigastric pulsations +
On auscultation - Loud S1 +
S2 split +










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