55 year old farmer came to the casualty with C/O of- -SOB grade IV since 4days -Abdominal distention with scrotal swelling since 1week -SOB on lying down since 3days with pedal edema Patient was apparently alright 6years back then developed SOB on doing routine work, progressing to even on walking for short distance, diagnosed as Right Heart Failure on treatment. Abdominal distention along with pedal edema since 1year, therapeutic tap was done in view of ascites twice before, last done 3months back. Symptoms aggravated since 1week associated with constipation, relieved on taking medication, associated with increasing SOB and Orthopnea. Associated with decreased urine output intermittently , facial puffiness and anasarca relieved on medication. Symptoms increased on intake of alcohol, non adherence to diet. PAST HISTORY- K/C/O COPD secondary to chronic smoker stopped 4years back gradually over a period of 2 years. 1pack beedi/day for 30years. K/C/O chronic occasional consumption o...