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56yr female with abdominal distension since 20 days

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  This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. This e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome. Pt came with the complaints of  Abdominal distension since 20 days Pedal edema upto knees since five days History of presenting illness  Pt was apparently asymptomatic 20 days ago then she developed abdominal distension, which was insidious in onset, gradually progressive in nature Abdominal tightness present  aggrevated after having food Patient has pedal edema since five days- on and-off which is continuous,pitting type, upto knee level  Patient complains of SOB when abdominal