A 72-year-old man presented in the OPD with chief complaints of painless swelling of both legs since 2 months. Initially, the swelling started at the ankles, but now his legs, thighs, and genitals were swollen. His face was puffy in the mornings on getting up. He put in 30 kg of weight over 3 months. He has noticed that his urine appears to be frothy in the toilet. He was experiencing shortness of breath but denies any chest pain. He has also developed spontaneous bruising over the past 6 months.
Medical history: He has been diagnosed with HTN 13 years ago and a myocardial infarction since 4 years. Medication history: Atenolol 50 mg once a day. Social history: He continues to smoke 30 cigarettes a day and drinks about 30 units of alcohol a week. Physical Examination: Pitting edema was noted to the level of the sacrum. There was also massive edema of the penis and scrotum. There was…
