23y old female with facial puffiness and pedal edema
23 year old female resident of vutikodu farmer by occupation came to OPD with chief complaints : Facial puffiness (on and off) since 5 months. Bilateral Pedal edema (on and off) since 5 months Shortness of breath (grade 2) since 5 months. Fatigue since 5 months. History of presenting Illness: Patient was apparently asymptomatic 5 months ago.Then she developed facial puffiness which was insidious in onset and gradually progressive in nature ,aggrevated while working in farm and relieved on medications . Bilateral Pedal edema since 5 months which was insidious in onset, gradually progressive in nature, aggrevated while working in farm and relieved on medications.It is pitting type. Shortness of breath (Grade 2) according to NYHA classification since 4 months. Sequence of events: Five months ago, patient developed facial puffiness, bilateral Pedal edema ,fever with chills and rigor .So she visited a near by hospital,took medication,but symptoms didn't relieve. Later,after 3days