Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain that it is necessary a medical check up by his cardiologist, as excessive fluid build up and also shaking hands and legs are expressions of heart failure decompensation. Shaking hands and legs may be due to profound weakness, any hemodynamic compromises, leading to relative hypotension. A careful physical exam to confirm the severity of systemic venous congestion, hemodynamic compromise, and identifying possible etiological causes of decompensation triggering, is necessary. It is recommended a resting ECG to identify a possible cardiac arrhythmia, a cardiac ultrasound for cardiac performance and degree of systemic congestion evaluation, chest X ray study, several blood tests (complete blood count for investigating possible arrhythmia and infection), PCR, thyroid, renal and liver function tests, blood electrolytes, fasting blood glucose, etc. Coming to this point, a diuretics treatment optimization coupled with additional therapy (according to actual clinical status) would be helpful in relieving edema and other complains. I recommend consulting immediately with his attending cardiologist for discussing about the above mentioned issues. Hope to have been helpful. Greetings! Dr. Iliri