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48 year old women with multisystem involvement

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Name;M.sandhya  roll no;89 Date; 30 March 2022 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 patient's 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 the comment box . 48 year old female , resident of Hyderabad and home -maker by occupation, presented to casualty on 14/3/22 . CHIEF COMLAINTS; SHORTNESS OF BREATH since 1 week - initially grade -2 later progressed to grade 4 . PEDAL EDEMA since 1 week CHEST TIGHTNESS since 1 week GENERALISED WEAKNESS AND FATIGUE AND FREQUENT FALLS since 1 week DIFFICULTY OPENING MOUTH AND ORAL ULCERS since 1 week. DIFFICULTY IN SWALLOWING BOTH SOLIDS AND LIQUIDS since