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 solveb 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 is welcome. CASE REPORT A 58 year old female came to OPD with shortness of breath. HISTORY OF PRESENTING ILLNESS Patient was apparently asymptomatic 10 days back then she developed swelling in the legs which is progressive, pitting in nature and gradually progressed up to the knee, accompanied with facial puffiness. Patient also had burning micturition and decreased urine output. Then she developed shortness of breath 3 days back. Which was persistent even while resting. (GRADE-4