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50 year old male with complaints of shortness of breath and vomiting

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Hi, I am Gaddam shreya of 3rd semester .This is an online E logbook to discuss our patient’s de-identified health data shared after taking his/her/guardian’s consent. This also reflects our patient centered online learning portfolio. The patient’s consent was taken verbally prior to history taking and examination of her condition. A 50year old male, labourer by occupation came to OPD with chief complaints of shortness of breath since 6days and vomiting since 4 days.  HISTORY OF PRESENT ILLNESS- Patient was asymptomatic 1 year back. Then he Diagnosed with chronic kidney disease he is on conservative treatment. SOB is insidious in onset, not present during rest and is more prevalent during night (PND). SOB is generally experienced after walking a short distance.The patient also complained that the breathlessness is increased by lying down suggesting orthopnea. Vomiting is present since 6 days immediately after intake of food No history of fever PAST HISTORY  The patient was known to be h