patient 55yrs old,shortness of breath on exertion for last 2months,nd shortness of breath on lying along wd cough nd frothy sputum,no edema,allergy,cough,had appendicitis 30yrs ago admitted to hospital for ami relieved by sublingual tablets no history hp ,dm,rf ex smoker 20-30yrs,his father died due to stroke nd mom alive,along wd it no cyanosis, jaundice,no ostler nodes no heberdens nodes or splinter hemorrhage heart exam:heart s1: diminished wd intensity s2:normal nd s3 audible at apex respiratory normal gitnormal nd cnsnormal diagnosis plus dd nd investigation