Congestive cardiac failure
Hx: Exertional dyspnoea, orthorpnea, florid cardiac history (e.g. ischaemic heart disease, old myocardial infarcts), or someone presenting for the first time with edema.
PE: Cardiomegaly, 3rd or 4th heart sounds.
Diagnosis: NT-proBNP levels or echocardiography.
If there is worsening of edema and/or progressive dyspnoea, look for an acute precipitant (e.g. new ischaemia, arrhythmia, or noncompliance to fluid restriction) which must be addressed.