Congestive Heart Failure (CHF): This diagnosis is the most likely due to the combination of symptoms such as cough, tachycardia (190bpm), pedal edema, and shortness of breath, which are classic presentations of CHF. The high heart rate could indicate compensatory mechanisms for decreased cardiac output.

Pulmonary Embolism (PE): Although less likely than CHF given the full spectrum of symptoms, PE could explain tachycardia and shortness of breath. However, pedal edema and cough are less typical for PE unless it's a large or recurrent embolism.
Chronic Obstructive Pulmonary Disease (COPD) Exacerbation: This could explain cough and shortness of breath, but tachycardia and pedal edema would be less common unless there's associated heart failure or significant hypoxia leading to pulmonary hypertension.
Pneumonia: Could explain cough, shortness of breath, and tachycardia, especially if the pneumonia is severe. However, pedal edema would be less typical unless there's associated sepsis or heart failure.

Cardiac Tamponade: Although less likely, cardiac tamponade is a life-threatening condition that could present with tachycardia and shortness of breath. Pedal edema might not be a direct symptom, but it could occur due to decreased cardiac output.
Pulmonary Edema due to Acute Coronary Syndrome: This is a critical diagnosis to consider, as it could explain all symptoms, especially if the patient has risk factors for coronary artery disease.
Severe Anemia or Sepsis: Both conditions can lead to tachycardia and shortness of breath. While pedal edema might not be directly related, it could occur in the context of sepsis due to capillary leak syndrome or in severe anemia due to heart failure.

Constrictive Pericarditis: A rare condition that could explain shortness of breath, pedal edema, and possibly tachycardia if there's significant impairment of diastolic filling.
Lymphangitic Carcinomatosis: A rare condition where metastatic cancer invades the lymphatic vessels in the lungs, leading to shortness of breath and possibly cough. However, tachycardia and pedal edema would be less typical unless there's associated heart failure or significant disease burden.
Thyroid Storm: Although rare, thyroid storm can cause tachycardia, shortness of breath, and possibly pedal edema if there's associated heart failure. Cough would be an atypical symptom unless there's associated pulmonary edema.