A 50yr old female with pedal edema

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This is case of 50yr old female with cheif complaints of pedal edema since 4daysand sob since 2days

HopI 

Patient was apparently asymptomatic since1year then she developed left knee joint pain then she went to the hospital and it is relieved after few days of usage of oral medication

After 7months ,she developed right knee joint pain for which she used normal pain killers. since 1month she is experiencing more right knee joint pain for which leg x-ray was done and few medication were given.(the day she was diagnosed with hypertension) .she has taken antihypertensive drug for 10days and then discontinued

Last sunday suddenly she developed chest pain immediately she went to the hospital where injection was given and got relief from pain.

She also complained of pedal edema up to the knee, facial edema since 4days 

She also complained of sob since 2days

Since 2days she is having urgency for urine and on the 2nd day frequency of urination is reduced .

Daily routine:

She wakes up at 5am and completes her house hold work .and sleeps by 9pm ,  

Past history

Not k/c/o diabetes,thyroid ,no history of blood transfusion 

General examination

Pallor: 

Icterus: absent 

Clubbing: absent

Cyanosis: absent

Lymphadenopathy: absent

Edema:pedal edema up to the knee 

Vitals:

Temp: afebrile on time of examination 

BP :

Heart rate 90 bpm

Resp Rate 20/min 

Abdominal examination::

Abdomen is obese

On palpation tenderness over right hypochondriac region 

And liver is enlarged 

And bowel sounds are heard 

Cvs examination:

S1 and S2 are heard