This is an online e logbook to discuss our patients deidentified health data shared after taking her/guardian's signed informed consent Here we discuss our individual patient 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 also reflects my patient centre’s online learning portfolio and valuable inputs on the comment box is welcome. A 45 year old gentlemen ,from ramanapet who is farmer by occupation came to the OPD with CHIEF COMPLAINTS: B/l Pedal edema since 3 months Shortness of breath since 2 months HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 3 months back then developed pedal edema, insidious in onset, bilateral ,gradually progressive from involving ankles to limbs (grade1to grade 3 ), pitting type ,aggravated by walking and by end of the day,relieved by elevating leg, then developed shortness of breath w