Thank you for getting in touch with us. From what I make out, patient is in severe distress. In many people, lung problems over a span of time can lead to pulmonary hypertension
and may then progress to heart failure
. As this patients has distended neck veins, pitting edema of the extremities, enlarged liver, it can be safely said that this patient is progressing to right sided heart failure. Increased hemoglobin
in this patient might be due to hypoxia caused by chronic bronchitis
. Hypoxia over a period of time leads to increased production of erythropoietin
by the kidney. Hope this helped.