Heart Failure: The combination of acute shortness of breath, wheezing (possibly indicating pulmonary edema), tachycardia, elevated blood pressure, and a history of lower limb swelling strongly suggests heart failure, particularly if the patient has a history of hypertension or other cardiovascular risk factors.

Asthma Exacerbation: Although less likely given the context of elevated BP and lower limb swelling, an asthma exacerbation could present with wheezing and shortness of breath. However, the presence of systemic signs like elevated BP and lower limb swelling makes this less likely.
Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: Similar to asthma, a COPD exacerbation could present with wheezing and shortness of breath, but the additional symptoms suggest a more systemic or cardiac issue.
Pulmonary Embolism: While this could cause acute shortness of breath and tachycardia, the presence of wheezing and lower limb swelling might be less typical, though not impossible, especially if the swelling is related to a deep vein thrombosis.

Pulmonary Edema due to Myocardial Infarction: It's crucial not to miss a myocardial infarction (MI) as the cause of heart failure symptoms. An MI can present atypically, especially in women, and the symptoms described could be indicative of an MI leading to heart failure.
Aortic Dissection: Although less common, an aortic dissection could present with acute shortness of breath, tachycardia, and elevated blood pressure. The presence of lower limb swelling could be due to involvement of the aorta supplying the lower limbs.
Severe Anaphylaxis: This is a life-threatening condition that could present with respiratory distress, tachycardia, and potentially hypotension (though the patient is hypertensive, anaphylaxis can have variable presentations). It's less likely given the specific combination of symptoms but should be considered, especially if there's a history of allergies.

Lymphangitic Carcinomatosis: A rare condition where cancer spreads to the lymphatic vessels in the lungs, causing shortness of breath. It's less likely given the acute presentation and the combination of symptoms.
Mitral Stenosis: A valvular heart disease that could lead to heart failure symptoms, including shortness of breath and possibly wheezing if there's associated pulmonary edema. However, it would typically have a more chronic presentation unless there's an acute change, such as a atrial fibrillation onset.
Thyroid Storm: A life-threatening condition that can cause tachycardia, hypertension, and potentially respiratory symptoms due to the hypermetabolic state. It's rare and would typically be accompanied by other signs of hyperthyroidism.