#Nocturnal Polyuria Causes
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Nocturia Drugs Market Insights: Innovations in Diagnostics and Personalized Medicine Driving Growth
The nocturia drugs market is undergoing a transformative phase, driven by advancements in diagnostics and personalized medicine. With the global market projected to reach USD 8.5 billion by 2034, these innovations are not only enhancing patient care but also opening new avenues for pharmaceutical companies and healthcare providers.
Advancements in Diagnostic Technologies
Accurate diagnosis is pivotal for effective nocturia management. Recent developments in diagnostic tools are enabling more precise identification of nocturia's underlying causes:
Wearable Devices and Mobile Health Applications: The integration of wearable technology and mobile health apps is revolutionizing nocturia management. These tools monitor bladder activity and sleep patterns, allowing for real-time symptom tracking and medication adherence. Such technologies facilitate better communication between patients and healthcare providers, leading to more tailored and effective treatment plans.
Artificial Intelligence (AI) in Diagnostics: Companies like Astellas Pharma are collaborating with digital health firms to develop AI-based diagnostic tools for nocturia. These tools aim to analyze patient data more efficiently, leading to quicker and more accurate diagnoses.
Personalized Medicine: Tailoring Treatments to Individual Needs
The shift towards personalized medicine is significantly impacting nocturia treatment strategies:
Pharmacogenomics: This field studies how a patient's genetic makeup affects their response to drugs. By understanding genetic variations, healthcare providers can prescribe medications that are more effective and have fewer side effects for individual patients.
Combination Therapies: Research indicates that combining desmopressin with anticholinergic drugs or β3 adrenoceptor agonists can significantly reduce nocturia episodes, especially in male patients with nocturnal polyuria.
Market Growth Drivers
Several factors are contributing to the growth of the nocturia drugs market:
Aging Population: The increasing prevalence of nocturia among the elderly is driving demand for effective treatments. As the global population ages, the need for nocturia management solutions is expected to rise.
Rising Awareness and Diagnosis: Greater awareness of nocturia and its impact on quality of life is leading to increased diagnosis rates. This trend is creating opportunities for pharmaceutical companies to develop and market effective treatment options.
Technological Integration: The adoption of digital health technologies, such as telemedicine platforms and mobile health applications, is enhancing access to healthcare services and improving patient outcomes.
Challenges and Considerations
Despite the promising outlook, the nocturia drugs market faces several challenges:
High Treatment Costs: The prohibitive cost of advanced nocturia medications poses a significant barrier, especially in developing nations. Specialized drugs like desmopressin and anticholinergics can be expensive, limiting accessibility for patients in low-income regions.
Stigma and Lack of Awareness: Many patients with nocturia dismiss treatment as an unavoidable consequence of aging, leading to widespread neglect and a lack of awareness about available therapies. This perception significantly hampers market growth for nocturia treatments.
The nocturia drugs market is poised for significant growth, fueled by innovations in diagnostics and personalized medicine. As technology continues to advance, and as awareness of nocturia increases, the market is expected to expand, offering improved treatment options and better quality of life for patients.
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How to Manage Urinary Leakage During the Night
For men living with urinary incontinence, nighttime can be one of the most frustrating and stressful parts of the day. You may fall asleep dry but wake up soaked, worried about your bed, your clothes, or even your dignity. The good news? There are practical, proven ways to manage urinary leakage at night — and you don’t have to give up restful sleep to regain control.
Let’s break down specific tips, tools, and strategies that help men handle overnight leakage confidently and comfortably.
Understand why nighttime leaks happen
Nighttime (or nocturnal) incontinence can happen for several reasons:
Overflow leakage: when the bladder doesn’t fully empty during the day.
Nocturnal polyuria: when the body produces more urine at night than usual.
Weak pelvic floor muscles or post-surgical changes after prostate treatment.
Mobility challenges: difficulty reaching the bathroom in time.
Knowing the cause helps you tailor your management plan. Always talk to your doctor first to rule out medical conditions like infections or diabetes that might worsen nighttime leakage.
Use purpose-designed products
Standard daytime pads or liners often aren’t enough for overnight use. That’s where urine bags for men come in. These bags, when connected to a secure incontinence system like the Afex® nighttime setup, can collect larger volumes of urine without needing to change or empty anything until morning.
Nighttime urine bags are designed to stay discreet, prevent backflow, and protect skin from irritation or infection. Pairing them with a well-fitting receptacle and support garment helps ensure they stay secure, even if you change positions in your sleep.
Consider mechanical supports
For some men, especially those with stress incontinence (leaks during movement or pressure), devices like the Cunningham clamp can help control urine flow. This small, adjustable device gently compresses the urethra, reducing or stopping leakage.
It’s important to use clamps correctly and under medical advice, as improper use can cause skin or tissue damage. But when used carefully, they can provide nighttime protection for select men.
Address related concerns, like erectile dysfunction
Many men facing urinary leakage also experience erectile challenges after prostate surgery or due to age-related changes. If you’re also managing ED, you might explore tools like the Encore ED pump — a vacuum device that helps achieve and maintain erections without drugs or surgery.
While it’s not directly related to incontinence management, addressing both issues together can improve your overall confidence and intimate well-being, making you feel more in control of your body.
Build a solid nighttime routine
Here’s a step-by-step plan for setting yourself up for dry, worry-free nights:
Limit fluid intake in the evening (without dehydrating yourself).
Empty your bladder fully before bed — double voiding (trying to urinate, relaxing, and trying again) can help.
Set up your nighttime incontinence system securely, whether that’s a urine bag, clamp, or specialized garment.
Protect your bedding with absorbent pads or waterproof covers, just in case.
Keep supplies nearby for quick changes if needed.
Talk to your healthcare provider
Don’t struggle in silence. Your doctor can offer medical treatments, bladder training exercises, or referrals to continence specialists. There may also be medications or surgical options available if conservative methods aren’t enough.
Final thoughts
Managing urinary leakage at night doesn’t mean sacrificing comfort or dignity. With the right tools — from advanced urine bags for men to mechanical aids like the Cunningham clamp — and supportive devices like the Encore ED pump for related concerns, you can sleep more confidently and wake up feeling more in control.
Remember, you’re not alone in this. Thousands of men successfully manage nighttime incontinence every day — and with the right plan, you can too.
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Understanding the Relationship between Kidney Disease and Sleep Problems
Kidney disease, a condition that affects millions of people worldwide, can have a profound impact on various aspects of daily life, including sleep. Individuals with kidney disease often experience sleep problems, which can further worsen their overall health and quality of life. In this article, we will explore the reasons behind the correlation between kidney disease and sleep problems, shedding light on the intricate relationship between the two.
1. Disrupted Fluid Balance:
One of the primary functions of the kidneys is to regulate fluid balance in the body. However, in people with kidney disease, this balance becomes disrupted, leading to excessive fluid retention or depletion. This imbalance can result in nocturnal polyuria, where individuals produce an excessive amount of urine during the night, causing frequent awakenings and disrupted sleep patterns.
2. Electrolyte Imbalance:
Kidneys play a crucial role in maintaining the proper levels of electrolytes, such as sodium, potassium, and calcium, in the body. When kidney function is compromised, electrolyte imbalances can occur, disrupting normal bodily functions. These imbalances can lead to muscle cramps, restless leg syndrome (RLS), and periodic limb movements during sleep (PLMS), all of which can significantly disturb sleep.
3. Sleep Apnea:
Kidney disease is often associated with a higher risk of developing sleep apnea, a sleep disorder characterized by pauses in breathing during sleep. The accumulation of fluid in the body due to impaired kidney function can cause fluid retention in the neck and upper airways, leading to narrowed air passages and increased episodes of apnea. Sleep apnea not only disrupts sleep but can also contribute to other health complications.
4. Uremic Toxins:
As kidney function declines, the body's ability to eliminate waste products, including uremic toxins, diminishes. The accumulation of these toxins in the bloodstream can lead to symptoms such as nausea, itching, and restlessness, making it challenging for individuals with kidney disease to fall asleep and stay asleep throughout the night.
Conclusion:
Sleep problems are a common occurrence in individuals with kidney disease. The disruption of fluid balance, electrolyte imbalances, sleep apnea, and the accumulation of uremic toxins all contribute to the complex relationship between kidney disease and sleep problems. Recognizing and addressing these issues is crucial for improving the quality of life for those living with kidney disease.
Mahe Health Care, a leading healthcare provider, understands the challenges faced by individuals with kidney disease. With a multidisciplinary team of experts, they offer comprehensive care and support to manage kidney disease and its associated complications, including sleep problems. By addressing the underlying causes and providing tailored treatment plans, Mahe Health Care aims to improve the overall well-being of their patients, enhancing their sleep quality and overall quality of life.
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Nocturia: Main Causes and Remedies
When you have to wake up more than once to urinate at night, you may always think it is because of the fluids you take before bedtime. However, it could be because you are suffering from nocturia, which forces one to wake up many times to urinate. While it is not a disease, it could be signaling some other conditions, but a medical expert can help to diagnose that.
Main Causes of Nocturia
The major causes of Nocturia include decreased bladder capacity, Overactive Bladder¸ sleep disruptions, the body producing excess urine at night, or other underlying health conditions.

Excess Urine Production
During the day, especially for people who spend most of their time standing or sitting, excess fluid accumulates in the legs. As one rests at night, the fluid flows back to the kidneys and is converted to urine. Excess urine production during the night is called nocturnal polyuria and is among the most common nocturia causes, estimated to contribute up to 88% of cases.
This urine production may also be a result of consuming excess fluids before bed. It could also be because of consuming diuretics. Some of the fluids you can avoid include caffeine and alcohol.
Sleep Disruptions
Sleep problems may also provoke cases of Nocturia. Obstructive sleep apnea (OSA) is one of the culprits, as it causes pauses in breathing during the night, disrupting sleep. It does this by reducing airflow and oxygen levels, which influences hormones, which may then induce excess urine production and nocturia.
Decreased Bladder Capacity
The bladder naturally has a capacity that it can hold at any given time. The capacity may diminish due to urinary tract inflammations, heightened urge incontinence, and bladder stones. If the capacity is inadequate, it may lead to nocturia.
Tips for Managing Nocturia for Better Sleep
A medical expert may diagnose and advise you on the best remedies you can take in this case. Most of the remedies will include medications or adjustments to existing medications. Lifestyle changes may also help, including:
Reducing the amounts of fluids that you take before bedtime.
Reducing or avoiding taking diuretic fluids, including coffee, chocolate, alcohol, and carbonated and caffeinated drinks.
Keeping your legs elevated for some time before bedtime to help in reducing the reabsorption and subsequent conversion of peripheral edema to urine when you sleep.
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Nocturnal Polyuria - Medicine for Night Urination
New research shows that most cases of notarial have a common cause: nocturnal polyuria. This is a condition in which your body produces too much urine during the night, causing you to wake up and go to the bathroom. It can be caused by an overactive bladder, a common complication of an aging prostate, or it can be caused by diabetes.
#Treatment of Nocturia#Desmopressin Acetate#What is Nocturia#Nocturnal Polyuria Causes#Sublingual Tablets Uses
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Why do we get the urge to frequently urinate at night?
Nighttime urination (nocturia) is a normal part of aging, but it can also be an indication of a medical problem such as diabetes, heart disease, or bladder problems. Some medical problems that result in nerve damage.
You may also wake up requiring to pee as a result of lifestyle variables (such as your diet) or medications you take. Because nocturia can cause sleep deprivation, daytime fatigue, poor concentration, depression, and loss of productivity, it's necessary to consult with a Urologist in Pune.
The most Common Causes of Frequent Urination at Night are-
Age-
One of the most important characteristics connected with nocturia is age. The majority of people who have the ailment are over the age of 60, while lower age can also be a factor in midnight urination. The disorder known as nocturnal polyuria is one well-known aging-related cause. (NP). As a result, the body produces large amounts of pee when sleeping. With age, the prevalence of nocturnal polyuria rises. The disorder affects approximately 77% of older women and 93% of older men. Younger people (particularly children) experience nocturia because their bladders have not yet gained their full size. The amount of urine produced at night may be greater than the organ's capacity.
Lifestyle and Diet-
The need to urinate at night might also be caused by a change in food. These variables can cause nocturia either directly (by causing the body to produce urine) or indirectly (by causing the body to produce urine). (By compressing the bladder).
Some of the most prevalent dietary components that contribute to nighttime urination include:
Caffeine and alcohol: Coffee, soda, and other caffeine-containing beverages, as well as alcoholic beverages, have diuretic qualities that enhance urine output.
Dietary salt: Excess salt (sodium) in the diet can cause nocturia in those who are obese or have low cardiac output. Sodium promotes fluid retention. When the bladder is full, the fluid may be expelled at night.
Hyper hydration: Drinking too much water before bedtime can easily result in a middle-of-the-night bathroom visit.
Low-fiber diet: Chronic constipation can occur if your diet is deficient in nutritional fibre. The accumulation of stool at night can cause the gut to stretch and put pressure on the bladder, giving you the urge to pee.
Pregnancy-
Nocturia can develop at any stage of pregnancy for a variety of reasons.
Early pregnancy: Progesterone levels rise in early pregnancy, causing bloating and water retention. This increases the likelihood of overnight urination. Nocturia can be an early indicator of pregnancy in some circumstances.
Later pregnancy: Frequent urination is usual throughout the second and third trimesters because the womb has begun to compress the bladder. Certain body positions at night can worsen the compression and cause nocturia.
After pregnancy: People may experience bladder and pelvic organ prolapse, which means the organs have slipped out of place. Both can cause urinary tract obstruction.
Medications-
Nocturia can also be caused by some drugs. This can occur in several ways:
A medication may cause the release of acetylcholine, a chemical that causes bladder contractions.
A medication may hinder the release of norepinephrine, a hormone that relaxes the bladder and other smooth muscle organs.
A diuretic effect occurs when a medicine helps the kidneys to excrete more salt and water from the body.
Acute Infection/ Conditions-
Nocturia can be a sign of acute urinary tract (urologic) diseases such as:
Kidney stones or bladder stones
Bladder infection (interstitial cystitis)
Kidney infection (pyelonephritis)
Urinary tract infection (UTI)
In acute situations, inflammation might cause a quick need to urinate due to urinary tract contractions. (Urinary urgency). Nocturia is frequently the continuation of a person's daytime urine urgency. When the cause of the inflammation is eliminated, the nocturia usually improves.
Chronic Disease/ Conditions-
Nocturia can sometimes be a sign of a more serious disease. In some cases, it might last a long period and be difficult to treat. Some of the causes are urinary-related, while others are not. The following are the common chronic causes of frequent urination at night
Benign prostatic hyperplasia (BPH)
Bladder cancer
Congestive heart failure (CHF)
Diabetes
Hypertension
Multiple sclerosis (MS)
Overactive bladder (OAB)
Parkinson's disease (PD)
Sleep apnea
Overweight/obesity
Neurogenic bladder
It can be annoying to your sleep if you have to wake up in the middle of the night to pee. While nocturia can be caused by something as simple as drinking too close to going to bed or having a small bladder, it can also be caused by certain medications and health conditions. Chronic disorders that destroy nerves, such as MS, can also cause bladder difficulties. Making adjustments to your lifestyle (such as decreasing weight or cutting back on alcohol) may assist with nocturia in certain circumstances. There are also therapies for many of the disorders that can cause it, which you can discuss with your provider. If you find that getting up to pee frequently disrupts your sleep, Consult the Best Urologist in Pune.
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Definition of nocturnal

Urinating more volume (if polyuria is present).Waking up more than once a night to urinate.This can cause disruptions in a normal sleep cycle. People who have nocturia wake up more than once a night to urinate. Normally, you should be able to sleep six to eight hours during the night without having to get up to go to the bathroom. Interstitial cystitis (pain in the bladder).Bladder infection or recurrent urinary tract infection.The causes of an inability of the bladder to fully fill can include: Benign prostatic hyperplasia (men), a non-cancerous overgrowth of the prostate that obstructs the flow of urine.The causes of an inability to fully empty your bladder can include: This can also occur due to difficulty sleeping - you may wake up for one reason, but then go to the bathroom while you’re awake, which will make you think that you woke up because you had to urinate. This is usually due to an inability of the bladder to fully empty (this is why it fills up faster) or the inability of the bladder to fill completely before developing the urge to urinate (low bladder volume). The total amount of urine produced is not elevated. If you have nocturnal urinary frequency, you may urinate in small amounts or urinate more frequently. Drinking too much fluid before bedtime, especially coffee, caffeinated beverages or alcohol.Certain drugs, including diuretics (water pills), cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D.Sleeping disorders, such as obstructive sleep apnea (breathing is interrupted or stops many times during sleep).Edema of lower extremities (swelling of the legs).The causes of nocturnal polyuria can include: It can re-enter your veins and be filtered by your kidneys, producing urine. Once you lie down to sleep, gravity no longer holds the fluid in your legs. This is usually due to fluid retention during the day that often accumulated in the feet or legs. Their urine volume during the day is normal or reduced. Those with nocturnal polyuria experience a high urine volume only at night. Diabetes insipidus, gestational diabetes (occurs during pregnancy).Untreated diabetes (Type 1 and Type 2).It can also happen if something is in the urine, pulling the extra water out, such as sugar (glucose). This is usually caused by there being too much water filtered by the kidneys. People with polyuria urinate >3,000mL in 24 hours. There are many possible causes of nocturia, depending on the type.

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Nocturnal Polyuria Causes | Medicine For Nocturia
The leading cause of nocturia is nocturnal polyuria (NP), a condition where the bladder contracts during sleep and fills with small amounts of urine. This frequent urination results in interrupted sleep, which can lead to excessive daytime sleepiness, fatigue, or loss of energy. For more information, visit: https://www.nocdurna.com/frequent-nighttime-urination/
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Is Nocturia keeping you Awake in the Night?
Nocturia is a condition that keeps you awake at night as you have the urge to urinate frequently. This affects both men and women and increases with age. Most people wake up once during the night to urinate, which is considered normal. But, waking up more than once is a sign that something is wrong.
What are the different types of Nocturia and their causes?
Now let us look into the types of nocturia and their causes:
Polyuria: People suffering from Polyurea urinate >2500 liters in 24 hours. This happens when there is too much water that is being filtered by the kidneys. High fluid intake, high diabetes, and gestational diabetes could be the cause of polyurea.
Nocturnal Polyurea: Noctural polyurea is the urge to pee only at night. Whereas their urine volume is normal durig the day. The fluid gets accumulated in the legs during the day leading to swelling of the legs. But, when you rest, the fluid from the swollen foot traces back to the kidneys, increasing the urge to urinate in the night. The causes of Nocturnal Polyurea may be a diet high in sodium, congestive heart failure, drinking too much fluids before bedtime, congestive heart failure,obstructive sleep apnea.
What are the symptoms associated with Nocturia?
The symptoms associated with Nocturia are:
Waking up more than once to urinate.
Sleeplessness and tiredness even after waking up.
Urinating in high volume.
What are the treatment options for Nocturia?
If you feel you are suffering from nocturea it is advisible to see the urologist. The best Urology Hospital in Bangalore will have all the facilities and experts to treat Nocturia. Let us look into the treatment available to treat Nocturia.
Restricting fluids in the evening.
Place the leg at an elevated position while sleeping.
Wearing compression stockings that prevent fluid accumulation.
The best Urologist in Bangalore may also prescribe a few medication to cure Nocturia.
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When the Symptoms of Heart Failure Are Getting Worse
New Post has been published on https://depression-md.com/when-the-symptoms-of-heart-failure-are-getting-worse/
When the Symptoms of Heart Failure Are Getting Worse

If you are living with heart failure that is no longer responding to conventional heart therapies and your symptoms are getting worse, you may have advanced heart disease.
About 6.2 million people are living with heart failure in the United States, and that number is expected to rise. Because improvements in the treatment of heart failure have allowed people with this condition to survive substantially longer than they used to, the number of people that reach an advanced phase of the disease—also called end-stage, refractory, or terminal heart failure—is steadily growing.
Heart failure is a slowly progressive condition that can be managed but not cured without getting a heart transplant. Fortunately, medical advances have improved the quality of life to such a degree that people can engage more fully in end-of-life decisions like palliative care.
This article discusses advanced-stage heart failure in detail.
Nipitphon Na Chiangmai / EyeEm / Getty Images
Advanced Stages
In advanced heart failure, the heart no longer pumps enough blood, either because the heart cannot fill up with enough blood or can’t pump forcefully enough to meet the body’s needs. The heart still beats, but it is weak and damaged. Even more, the body is unable to compensate for the reduced blood the heart can pump. As a result, fluid often backs up into the lungs, liver, abdomen, or legs.
The most common symptoms of advanced heart failure are shortness of breath and chest pain at rest, or with minimal exertion.
The New York Heart Association classification system is the simplest and most widely used method to gauge symptom severity.
Class I
No limitations of physical activity
No heart failure symptoms
Class II
Mild limitation of physical activity
Heart failure symptoms with significant exertion; comfortable at rest or with mild activity
Class III
Marked limitation of physical activity
Heart failure symptoms with mild exertion; only comfortable at rest
Class IV
Discomfort with any activity
Heart failure symptoms occur at rest
Another classification system is the American Heart Association and American College of Cardiology’s A-to-D staging system. In this system, advanced heart failure is stage D.
Stage A: You have been diagnosed with coronary artery disease, hypertension, or diabetes mellitus, but you have yet to develop left ventricular hypertrophy, distortion of the chamber, or impaired function on echocardiogram
Stage B: You are asymptomatic but demonstrate left ventricular hypertrophy and/or impaired left ventricular function on echocardiogram.
Stage C: You have had symptoms of heart failure, but it is managed with standard treatment.
Stage D (advanced or refractory): You experience symptoms on minimal exertion or at rest in spite of optimal medical therapy and deteriorate clinically requiring repeated hospitalizations.
Heart failure is considered end-stage when life expectancy is predicted to be six months or less. Palliative or hospice care and novel research therapies are usually discussed during the final stage of heart failure.
Symptoms
Common symptoms of left-sided heart failure include:
Chest pain
Fatigue
Weakness
Shortness of breath, especially on exertion
Orthopnea, or shortness of breath when lying down
Paroxysmal nocturnal dyspnea, or awakening at night with shortness of breath
Exercise intolerance
Fast or irregular heartbeat
Peripheral edema, or swelling of the feet, angle, legs
Weight gain
Nausea
Persistent coughing or wheezing
Having to urinate more than usual (polyuria) or at night (nocturia)
When the heart is weak, fluid builds up throughout the body, causing problems. Symptoms include swelling of the feet, legs, and/or belly and having more shortness of breath. You may also feel nauseous and lose your appetite. Other common signs of progressing illness are feeling dizzy or faint and cold hands and feet due to poor blood circulation.
These common symptoms become worse as heart failure progresses and may look different at advanced stages.
Shortness of Breath
A weak heart cannot pump blood forward so it backlogs into the lungs making it difficult to breathe. During advanced heart failure, you may experience shortness of breath, or dyspnea, even with minimal exertion.
This shortness of breath is likely due to fluid overload on and around the heart and may feel like suffocating, smothering, and hungering for air.
Edema
Severe heart failure can result in blood and fluid pooling in the legs and abdomen. The body can usually accommodate large increases in volume, about five liters, but in severe heart failure, the extra fluid is enough to expand the extracellular compartments of the body.
Swelling is usually most pronounced in the feet and ankles, but the development of ascites—fluid buildup around the liver and abdomen—has an especially poor prognosis.
Of note, edema in heart failure is different from edema caused by other conditions, in that it creates a dimple when pressed. Therefore, edema caused by heart failure is also called pitting edema.
Sudden Weight Gain
During heart failure exacerbations, it is not uncommon for the body to rapidly gain weight as a result of fluid retention, sometimes as high as five pounds or more in a day.
Sleep Problems
In advanced heart failure, fluid accumulates in the lungs and more diuretic medicine is needed. Unfortunately, diuretic resistance develops in the final stages of heart failure as the body kicks fluid-retaining systems into high gear.
When you lie down, fluid accumulation in the lungs signals the body to wake up to prevent asphyxiation. This phenomenon is called paroxysmal nocturnal dyspnea. It is not uncommon for people to wake up multiple times in the night or find it hard to find a comfortable sleeping position.
Many people with heart failure also have sleep apnea, so they may misattribute their symptoms. If you have heart failure and are frequently waking up in the middle of the night, it may be a sign of worsening heart failure, so you should contact a healthcare provider immediately.
Coughing and Wheezing
Fluid in the lungs, or pulmonary edema, can cause coughing or wheezing. In more severe cases, these symptoms can resemble asthma, hence the going usage of the term cardiac asthma to describe these symptoms.
Symptoms of severe cough, wheezing, and spitting up pink-colored sputum should not be taken lightly, and you should contact a medical professional at the first sight of these symptoms.
Treatment
If your symptoms do not respond to changes in medications, you may have a condition called acutely decompensated heart failure (ADHF).
Many times symptoms of advanced heart failure respond to a course of treatment in the hospital and you feel much better upon discharge, but sadly some people do not improve to the point where they can go home on oral medications alone. This is due, in part, to the ineffectiveness of diuretics, a term called diuretic resistance—or decreased natriuresis and diuresis—as a result of the body’s overactivation of the SNS system—the part of the nervous system that increases heart rate, blood pressure, breathing rate, and pupil size—and the RAAS system, which regulates blood pressure.
Sometimes medications may work to some degree but make you feel worse. Decreased cardiac output worsens kidney function and activates the SNS and RAAS systems, enhancing sodium and water retention. Once-helpful diuretics can actually worsen heart failure by worsening the glomerular filtration rate of the kidneys and hyponatremia, or low sodium levels.
Diuretics may also instigate electrolyte abnormalities, further complicating treatment.
So what are the options at this point? You’ll likely need advanced treatments such as:
Constant intravenous (IV) medications: Continuous IV medications are used for those who are getting partial relief and desire a higher quality of life. They are often used as a bridge to transplant or palliative care. Also, most insurance companies cover this service, so it is widely available to those who cannot afford other end-of-life treatment options.
Mechanical circulatory support (partial or total artificial hearts): An intra-aortic balloon pump (IABP) or ventricular assist devices (VADs) can aid the heart in pumping and effectively delivering blood to the body, but they are mostly used as a bridge to recovery or heart transplantation. IABP has emerged as the single most effective and widely used circulatory assist device, but the invasive nature of the procedure needed to place the device comes with risks of thromboembolism, bleeding, and infection.
Heart transplant: Heart transplantation is the treatment of choice for patients with heart failure refractory to medical therapy, but there are more people in need of a heart transplant than there are donors. According to the International Society for Heart and Lung Transplant, patient survival at one and three years for patients who received cardiac transplantation was approximately 85% and 79%, respectively.
Maintaining your heart failure self-care routine is vital to preserving and improving your quality of life no matter which treatment options you choose. This includes:
Limiting your salt to 2,000 mg of sodium per day
Restricting fluids like water, sodas, coffee, and soups to help avoid fluid buildup
Keeping a log of your weight and symptoms, and knowing the side effect profile of new and current medications
Receiving vaccinations for pneumonia and influenza
Continuing to treat pre-existing health conditions like high blood pressure and diabetes
Prognosis
Heart failure is associated with very high morbidity and mortality. Eighty percent of men and 70% of women over the age of 65 who are diagnosed with heart failure will die within eight years.
Stage D heart failure has a more grim prognosis. Despite improving special therapeutic interventions, the one‐year mortality rate of refractory heart failure is approximately 50%.
The most common cause of death is progressive heart failure, but sudden death may account for up to 45% of all deaths. Also, Black people are 1.5 times more likely to die of heart failure compared to White people, underscoring the health disparities that persist in the United States.
Symptoms of advanced heart failure are manifestations of severely low cardiac output. The following signs may be indicative that someone is dying of heart failure, especially if frequent hospitalizations and specialized treatment regimens are not leading to clinical improvement:
Early satiety
Poor appetite
Abdominal pain
Nausea
Coughing up pink sputum
Renal insufficiency
Forgetfulness and memory problems
Coping
Heart failure can have a significant impact on your mental and emotional health. Feelings of anger, sadness, and fear are natural. Talking to your friends and family about how you are feeling, and seeking professional help if necessary, may help you to feel better and avoid heat-of-the-moment decisions that you may regret later.
The progression of heart failure can be unpredictable, which makes it difficult to know when to have conversations about end-of-life care. It’s important to discuss things as early as possible, giving people the time to think about treatment options and where they want to be cared for toward the end of their life. This may help them achieve some peace of mind and a sense of control.
While you have the final say on your treatment options and end-of-life care, shared decision-making that includes trusted healthcare professionals and your family means that you don’t have to make crucial decisions alone.
A Word From Verywell
If your heart function doesn’t improve or worsens in spite of the best possible self-care and medical treatments, you may have to consider other options like heart surgery, continuous infusion of intravenous drugs, and heart transplant.
Research shows people are happiest and most satisfied with their end-of-life decisions when they’ve made them with their doctors and family members, a process called shared decision-making. During this time you may want to discuss end-of-life measures like palliative care and assigning a power of attorney.
Living with advanced heart failure is not easy, and end-of-life conversations can be difficult. While you may feel scared or like you are losing control, leaning on your family and friends during these difficult times can assure that all your end-of-life needs and wishes are met.
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Nocturnal Polyuria Medicine | Medicine for Night Urination
Are you experiencing a symptom called Nocturia? Then visit NOCDURNA to learn about Nocturnal Polyuria, a major cause of nocturia, prescribing information, and Medication Guide for NOCDURNA.
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Nocturia
Nocturia, also known as nocturnal polyuria, is the clinical term used for referring to continuous urination during night. As we sleep, our body produces lesser quantity of concentrated urine. This implies that we do not usually feel the need to wake up and urinate at night, and are able to sleep peacefully for at least 6 to 8 hours. It is advisable to consult a medical urologist at the earliest.
Causes Nocturnia may occur due to a wide range of causes including medical conditions, lifestyle choices, food habits, etc. Although this condition is commonly seen in older adults, it may occur at any age.
Medical conditions that cause Nocturnia
A number of medical conditions may lead to nocturia. Some of the more common ones are bladder infection and urinary tract infection (UTI). This type of infection creates a constant burning sensation and an urge to urinate throughout the day and even at night. Antibiotics are usually required for its treatment.
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Nighttime Urination: Causes, Treatments, And Prevention
Are you the type of person that likes urinating excessively at night? If yes, then this informative article is for you.
What Is Nocturia?
Nocturia, or nocturnal polyuria, is the medical term for excessive urination at night. During sleep time, your body produces less urine that is more concentrated. This means that most people don’t need to wake up during the night to urinate and can sleep…
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Prostate Cancer and Enlarged Prostate - Causes, Symptoms, Prevention and Treatment
We know that starting at age 40, the levels of the by-product prolactin of testosterone of men increases, stimulating the production of the enzyme 5-alpha reductase that causes the conversion of testosterone to gihydro-testosterones DHT triggering prostate enlargement and Prostate cancer. Therefore in order to prevent the symptoms of enlarged prostate and prostate cancer are to naturally impend the conversion of testosterone to DHT. Unfortunately, aging is not the only causes of enlarged prostate and prostate cancer. In this article, we will discuss other causes of prostate enlargement and prostate cancer.
I. Causes of enlarged prostate and prostate cancer
1. Genetics Genetics may also play a role in enlarged prostate since study shows that prostate cancer and enlarged prostates can be inherited from generation to generation.
2. Hormone imbalance The outward appearance of a typical middle-aged person shows increased abdominal fat and shrinkage of muscle mass, which is the main factor causing hormone imbalance. Hormone imbalance is also caused by depression, stress, and anxiety that are the most common psychological complications of hormone imbalance.
3. Cell-growth factor For whatever reason, some people have implicated in enlarged prostate that is a growth factor.
4. Mineral deficiency Our prostate contains high amounts of zinc to function normally. Zinc deficiency causes the prostate to enlarge. This may be due to aging or uncontrolled diet with excessive alcohol drinking.
5. Obesity Study shows that uncontrolled diet that is high in saturated and trans fats are the main cause of hormone imbalance that results in prostate enlargement. Researchers suggest that excess calorie consumption could somehow directly stimulate prostate enlargement because the excess body fat that accumulates causes an imbalance of hormone levels.
6. Testosterone Testosterone deficiency may be caused by high amounts of the by-product prolactin of testosterone of men in the body that stimulates even higher productions of the enzyme 5-alpha reductase resulting in a high amount of the conversion of testosterone to gihydro-testosterones DHT thus triggering prostate enlargement. Excess estrogen seems to be the culprit in prostate enlargement that leads to the pathology and favors the development of prostate cancer.
III. Symptoms
1. Nocturia. Nocturia is defined as being awakened at night one or more times in order to pass urine. It becomes more common as the person becomes older. This common pattern seen among people with this condition is an increased number of times of waking up every night to urinate for the rest of their life.
Nocturnal Polyuria is an important cause of nocturia in which there is an overproduction of urine at night. It is defined to have nighttime urine volume that is greater than 20-30% of the total 24 hour urine volume. Nocturia occurs more commonly among older people. It also occurs in women and men differently. Women generally experience nocturia as a result from childbirth, menopause, and pelvic organ prolapse. Nocturia in men can be directly attributed to benign prostatic hyperplasia (BPH), also known as enlarged prostate.
2. Dysuria. Dysuria is a complication associated with genitourinary infections usually resulting in painful urination because the infection has made its way into the urinary tract, resulting in a urinary tract infection. Dysuria in men is usually indicative of a complication of the prostate, commonly referred to as prostatic hyperplasia caused by hormonal imbalances associated with estrogen production.
3. Asymptomatic As we know the prostate gland becomes enlarged as a man ages. Asymptomatic inflammatory prostatitis may be diagnosed when infection-fighting cells are present causing common symptoms of prostatitis such as difficulty with urination, fever, and lower back and pelvic pain.
4. Epididymitis Epididymitis is an inflammation of the epididymis that connects the testicle with the vas deferens. Epididymitis is usually caused by infection of the urethra or the bladder. Epididymitis may begin with a low grade fever and chills with a heavy sensation in the testicle which becomes increasingly sensitive to pressure or traction.
III. Prevention and treatment
A. With Foods
1. Tomato Tomatoes contain a high amount of lycopene that can help to protect the prostate and keep it healthy, but raw tomato is hard to digest. Be sure to take tomato with dark green leafy vegetables for helping the absorption of lycopene.
2. Soy bean and legume Soybeans and legumes contains isoflavones and is a unique source of phytochemicals It directly inhibits the growth of different types of cancer cells and protects the prostate from being enlarged. Study shows that isoflavones were found to markedly inhibit prostate tumors in mice implanted with prostate cancer cells. Try adding soy or rice milk to your morning cereal or oatmeal.
2. Grapefruit Grapefruits contain high amounts of vitamin C, minerals, bioflavonnoids and other plant chemicals that help to prevent enlarged prostate, prostate cancer and other forms of cancer and heart diseases.
3. Papaya Papayas are rich in antioxidants, vitamin E, vitamin C, vitamin A, carotenoids and flavonoids that have cardio protective and anti-cancer effects. Eating papayas help to promote lung health and prevents the prostate from becoming enlarged and prevents prostate cancer.
4. Bean Beans are rich in inositol pentakisphosphate. Beans are high in fiber, which helps the body rid itself of excess testosterone that reduces the conversion of testosterone to gihydro-testosterones DHT thus triggering prostate enlargement and other problems.
5. Green tea Green tea contains the antioxidant phytochemicals called polyphenols that attack growth factors and proteins, interrupting processes that increase the size of tumors, thus preventing them from spreading to other parts of the body. Green tea also help to prevent the development of benign prostate hyperplasia such as enlarged prostate and prostate cancer.
6. Broccoli Broccoli and other cruciferous vegetables, including kale and cauliflower, are rich in sulphoraphane, a cancer-fighting phytochemical that helps rid the body of excess testosterone and reduces the risk of benign protatic hyperplasia and prostate cancer.
7. Cold water fish Cold water fish contains high amounts of Omega-3 fatty acids. Study shows that omega-3 fatty acids inhibit carcinogenesis that helps significantly lower levels of omega-3 polyunsaturated fatty acids in men with benign prostate hyperplasia and prostate cancer.
B. With Supplements
1. Bee pollen Bee pollen is an antioxidant containing high amounts of flavonoids, zinc and many other elements needed by our bodies. It has an astounding record at reversing prostate cancer and other prostate problems such as enlarged prostate.
2. Prostate glandulars Animal prostates contain high amounts of zinc that nourishes the human prostate.
3. Alanine Since alanine is present in prostate fluid, it plays an important role in prostate health. This has been confirmed in some studies that Alanine helps in preventing enlarged prostate and helps in strengthening the immune system.
4. Glutamics acid The fluid produced by the prostate gland also contains high amounts of glutamic acid, and may play a role in the normal function of the prostate. High dosages of glutamic acid may cause headaches and neurological problems and people with kidney or liver disease should not consume high intakes of amino acids without first consulting with your doctor.
5. Glycine Glycine is also found in fairly large amounts in the prostate fluid and may for this reason be important in prostate health. It is required to build proteins in the body and synthesis of nucleic acids, the construction of RNA as well as DNA, bile acids and other amino acids in the body. Study shows that glycine, taken withalanine and glutamic acid help to reduced the amount of swelling in the prostate tissue.
6. Lycopene The substance found in tomatoes, fruits and vegetables can prevent and slow down prostate inflammation and prostate cancer. Study shows that lycopene helps to decrease in DNA the damage to prostate cells. Lycopene also protects against LDL cholesterol oxidation.
C. With Herbs
1. Saw palmetto Saw palmetto is the number one choice when it comes to prostate health. Recent study of American Society for Cell Biology shows that saw palmetto inhibited prostate cancer cell growth in the test tube. It has been used for a long time as an herb to treat an enlarged prostate gland in men. It may also be used to treat prostate cancer. This herbal remedy has no significant side effects and only rarely causes mild stomach upset or diarrhea.
2. American Ginseng The roots, has been used for centuries in Asian medicine as an aphrodisiac, a tonic for well being and a curative. American Ginseng is helpful in treating prostate problems due to low testosterone and androgen levels. It also inhibits cancer cells proliferation in a variety of cancer such as lung cancer, colon cancer and prostate cancer.
3. Corn silk Corn silk contains certain therapeutic properties that help to relieve the inflammation of the prostate. Corn silk are also popular as an alternative to standard Western allopathic medicine for treating bed-wetting and obesity.
4. Pumpkin seed extract Pumpkin seeds contain high amounts of zinc and fatty acids which is necessary for the prostate's health. Pumpkin seed extract helps to tone the bladder muscles, relax the sphincter mechanism and recongest the prostate.
5. Pygeum Africanum Pygeum Africanum is rich in phytosterols, the substances that inhibit the biosynthesis of prostaglandins, which is the process responsible for prostate inflammation. Phytosterols also help to reduce the size of the prostate, promote normal urination and reduce cholesterol deposits in the prostate that can occur with BPH.
6.Essiac Essiac is useful to regulate prostate gland function, stimulates gland activities, promote circulation of blood, relieves pain and inflammation and may permit increase sexual activities. Study shows that essiac possesses potent antioxidant and DNA-protective activity, properties that are common to natural anti-cancer agents.
7. Uva ursi Uva ursi is an evergreen perennial shrub. It has been used since the year 150AD by various civilizations to treat urinary tract infections, kidney problems, Prostate, and bladder dysfunction.
8. Soy isoflavones Study shows that an increased soy intake is related to a reduced risk of prostate cancer. Vitro tests showed that soy isoflavone inhibits growth of both androgen-sensitive and androgen-independent prostate cancer cells.
D. With Chinese Herbs
1. Saw palmetto Saw palmetto has been used for over a century in traditional Chinese medicine in treating pain in the lower back, inflammation and enlargement by inhibiting dihydrotestosterone, thereby reducing its stimulation for cancerous cell multiplication.
2. Patrinia (Bai jiang cao) Patrinia helps the body get rid of prostate inflammation and damp heat that exists in the body. In Chinese medicine damp heat in the prostate could be caused by bacteria infection, drugs and other conditions such as a habit of eating hot, spicy or greasy foods.
3. Lu lu tong (liquid amber) Lu lu tong has the ability to improve qi and blood circulation . It also helps to reduce the abdominal, back and knee pain caused by damp heat as well as difficult urination because of bladder or prostate inflammation.
4. He shou wu He shou wu contains several derivatives of tetrahydroxystilbene. These antioxidants and anti-inflammatory compounds may act as an estrogen, reducing levels of circulating male hormones such as DHT that fuel the growth of prostate cancer.
5. Niu xi (Achyranthes) Niu xi contains triterpenoid saponins and sitosterol that possesses anti-inflammatory effects in both enlarged prostate and prostate cancer inflammation. It also helps to nourish the kidney liver and reduce symptoms of damp heat and difficult urination as well as stiffness and pain of lower back.
6. Gui Zhi (tokoro) Gui Zhi is used for urinary tract disorder that pertains to ying qi levels which is the main cause of prostate inflammation. It also is used as a tonic and blood purifier.
7. Astragalus root Astragalus root is a sprawling perennial legume. The Chinese medicine uses the dried sliced or powdered root of the plant to enhance immune function by increasing the activity of certain white blood cells, which increases the production of antibodies. It also helps to increase the body's resistance to infections, to heal the allergies, and to raise and renew the vitality.
8. Che Qian zi (plantago seed) It is mainly used for stone strangury caused by lower burner damp-heat, such as the symptoms of aching pain in the lumbus and abdomen, poor urination or with hematuria, and urinary tract stones.
9. Vaccaria seed It is used to reduce pain and stiffness in the lower back, drain excessive damp heat, invigorate blood and treat difficult urination.
E. With Vitamins & Minerals
As we mentioned in previous articles, We know that starting at age 40, the levels of by-product prolactin of testosterone of men increases, stimulating the production of the enzyme 5-alpha reductase that causes the conversion of testosterone to gihydro-testosterones DHT triggering prostate enlargement and other problems. Besides aging there are many other causes of enlarged prostate and some of them might result in prostate cancer. Beside foods nutrition and herbs, vitamins and minerals also play an important role in preventing and treating prostate enlarged as well as prostate cancer.
1. Zinc Zinc is necessary for male sexual and prostate health. Zinc inhibits the uptake of testosterone into prolactin. The prostate gland contains a higher concentration of zinc than any other organ in the body, therefore zinc deficiency is the major cause of enlarged prostate as well as an early indication of prostate cancer.
2. Selenium Selenium contains an antioxidant enzyme that helps to enhance immune function, stop early cancer cells in their development and control cell damage that may lead to cancer. Foods that contain high levels of selenium are bran, broccoli, eggs, mushroom, and basil nut.
3. Vitamin C As we know Vitamin C, a water-soluble vitamin, is commonly known as an antioxidant. Some studies show that increased levels of vitamin C reduce the risk for prostate cancer as well as prostate inflammation and enlarged prostate.
4. Vitamin D Vitamin D is found in foods and is also produced by the body and activated after exposure to ultraviolet light from the sun. Studies show that activated vitamin D may be broken down in the prostate, where it may plays an important role in preventing enlarged prostate and prostate cancer. Vitamin D deficiency may increase the risk of prostate cancer.
5. Vitamin E Vitamin E plays an important role in preventing prostate cancer because it interferes with prostate specific antigen (PSA) and androgen receptor proteins that play a central role in the development of the disease.
F. With Homeopathic Remedies
1.Chimaphilia Chimpaphilia acts principally on kidneys, and genito-urinary tract; affects also lymphatic and mesenteric glands. It helps in treating urge to urinate with burn pain, strain to urinate and prostate enlargement and irritation.
2.Conium maculatum Conium maculatum is an excellent remedy for old age people. It helps to improve prostate enlargement, difficult urination, weakened urine flow and soften the prostate and enhance sexuality.
3. Hepar sulphuris calcareum Hepar sulphuris calcareum is a mixture powder of oyster shells and pure flower of sulfur. You can purchase in mixture in a health food store and follow the instructions to make your own. Hepar sulphuris calcareum has proven record in treating dribbling urine and poor flow.
4. Sabal serrulata Sabal serrulata is homeopathic to irritability of the genito-urinary organs. It is helpful in treating difficult urination caused by enlarged prostate, constant desire to urinate, as well as sexual inability.
5. Staphysagria Staphysagria is helpful in treating diseases of the genito-urinary tract such as the urge to urinate, inability to urinate fully and feeling of bladder not being empty.
6. Thuja The main action of thuja is on the genito-urinary organs. It is helpful in treating enlarged prostate, sudden desire to urinate and split urinary stream.
G. With Common Sense Approaches
1. Reduce fat and cholesterol intake, especially saturated fats. Study shows that if you eat more than 5 servings of red meat every week you could increase the risk of enlarged prostate and prostate cancer by 80%. By eating less of red meat and replacing them with cold water fish, you are ensured yourselves to get enough omega fatty acid that helps to improve your prostate health, reduce cholesterol levels, lower the risk of enlarged prostate as well as prostate cancer.
2. Eat foods containing more zinc (nuts- especially walnuts, pumpkin, seeds, safflower seeds and oysters). Zinc is an essential mineral for prostate health. It helps to reduce the size of the prostate and relieve symptoms of enlarged prostate. Foods containing zinc also contain cucurbitacines, chemicals that stop testosterone from changing to stronger forms of testosterone which encourages too many prostate cells to grow. Foods that contain cucurbitacines are nuts, walnuts, pumpkin seed, and oyster.
3. Guard your prostate with green tea Green tea contains catechins, a chemical that helps our immune system to track down tumor cells before they can do any harm to the prostate cells. Green tea may be one reason that Asian people have far fewer cases of prostate cancer than North Americans.
4. Remove all chemicals and pesticides from diet (eat organic food). Chemicals and pesticides in the processing food is toxic to our body. Intaking high doses of these poisonous chemicals will danger our immune system as well as cause inflammation of the body including the prostate.
5. Increase consumption of plants high in the sulphurophanes Study shows that you could reduce the risk of prostate cancer and prostate enlargement by 45% if you eat 24 or more servings of vegetables that contain high amounts of sulphurophanes such as broccoli, cauliflower, brussel sprouts, and cabbage.
H. Activities That Help to Maintain a Healthy Prostate
1. Moderate exercise (like walking) We know that one half to three-quarters of men older than 75 will have some cancerous changes in their prostate glands. People doing moderate exercise like walking for 2 to 3 hours per week had a 25 percent less risk of developing prostate problems than those who did not. Just 20-30 minutes walking a day would help to increase circulation of blood to the body as a side benefit for better sexual function and prostate health.
2. Sitz baths It is one of the earliest prostate treatments and the most effective remedies for prostate pain. This special bath brings a great flow of blood to a specific area of the body while the regular hot bath is pleasant and generally increases circulation throughout your body.
3. Yoga Yoga is really helpful to the prostate. It also helps tone the deep pelvic muscles there by promoting circulation. Yoga promotes flexibility, circulation, and stimulates the liver meridian. In general yoga helps a person to be more aware of his pelvic area in terms of his muscular control.
4. Kegal exercise Kegal exercise when performed while in virasana, bhekasana or frog pose also promotes good prostate health and overall benefit to the urogenital tract.
5. Spinal and pelvic massage Spinal and pelvis massage helps to a) Increase blood supply to the prostate and the pelvic area. b) Increase lymphatic flow to the prostate and the pelvic area. c) Reduces inflammatory conditions.
6. Joyful sex life Sex helps increase movement of the pelvic muscles and the blood circulation to all organs of your body. As fresh blood supply arrives your cells, organs and muscles are saturated with fresh oxygen and hormones, and as the used blood is removed, you also remove waste products and toxins from your body, thus reducing the risk of inflammation of the prostate.
You can see there are many different methods that help to maintain a healthy prostate. I hope this information will help. if you need more information. please visit my home page at:benign prostatic hypertrophy treatment
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Left-Sided Heart Failure: Overview and More
New Post has been published on https://depression-md.com/left-sided-heart-failure-overview-and-more/
Left-Sided Heart Failure: Overview and More

The signs and symptoms of left-sided heart failure can be confused with another medical condition or even go unnoticed. Edema, fatigue, and shortness of breath—even in the absence of chest pain—can be signs of a failing heart.
The left ventricle (LV) is the chamber that is responsible for pumping blood from the heart to the rest of the body. Dysfunction of the left ventricle leads to two types of heart failure: systolic and diastolic.
Heart failure (HF) is common in the United States with over six million people. Additionally, nearly one million new cases are diagnosed each year. Fortunately, medical advances have made it possible to manage heart failure.
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Types of Left-Sided Heart Failure
The heart has two main pumping chambers: the right ventricle and the left ventricle. The right ventricle receives deoxygenated blood from the body and sends it to the lungs, where it picks up oxygen. The larger and more powerful left ventricle pumps oxygenated blood to the body through the aorta.
Conditions such as hypertension, obesity, and coronary heart disease make the heart have to work harder to pump the same amount of blood. Over time, the heart’s main pumping power source is gradually weakened and can no longer handle the blood that it is receiving from the lungs. When this happens, heart failure occurs.
There are two types of left-sided heart failure:
Heart failure with preserved ejection fraction (HFpEF), also called diastolic heart failure: In this type, the heart muscle contracts normally, but the ventricles do not relax as they should during ventricular filling (or when the ventricles relax).
Heart failure with reduced ejection fraction (HFrEF), also called systolic heart failure: In this type, the heart muscle does not contract effectively, and less oxygen-rich blood is pumped out to the body.
Left-Sided Heart Failure Symptoms
You may not notice the signs of left-sided heart failure right away. Or you might attribute any mild symptoms you have to something else, such as allergies, congestion, indigestion, or a cold.
As the heart weakens, fluid backs up into the lungs and around the heart. When this happens, your symptoms may get worse and prompt you to seek medical care.
Older adults and people who are obese may have atypical signs and symptoms of heart failure Any sign of chest discomfort or a rapid decline in health should be treated as a medical emergency.
The symptoms of left-sided heart failure include:
Chest pain
Fatigue
Weakness
Shortness of breath (especially on exertion)
Orthopnea (shortness of breath when lying down)
Paroxysmal nocturnal dyspnea (awakening at night with shortness of breath)
Exercise intolerance
Fast or irregular heartbeat
Peripheral edema (swelling of the feet, ankles, and legs)
Unexplained weight gain
Nausea
Persistent coughing or wheezing
Having to urinate more than usual (polyuria) or at night (nocturia)
As time goes on, your heart may try to compensate by pumping harder to meet your body’s blood and oxygen demands. This causes more damage, which can lead to:
Enlarged heart
Rapid heart rate
High blood pressure
Less blood flow to the arms and legs
Early diagnosis and treatment can help slow the progression of left-sided heart failure and help you learn to adequately manage your symptoms. If undiagnosed and untreated, left-sided heart failure can cause complications like kidney or liver disease and heart attack.
Causes
The most common cause of heart failure is reduced left ventricular myocardial function. There are two types of dysfunction: systolic and diastolic.
Systolic dysfunction (HFrEF) is often due to:
Diastolic dysfunction (HFpEF) is most often due to:
Below is a list of the most common causes of left-sided heart failure and explanations on how these conditions contribute to heart failure.
High blood pressure: Chronic hypertension is one of the most common causes of diastolic heart failure. High blood pressure over a long time means that the heart has to work harder to pump blood through the body. As a result, the heart gets more muscular and stiffer, which affects its ability to relax during the resting stages of the cardiac cycle when it fills with blood.
Diabetes: High blood sugar levels are toxic to blood vessels and may cause them to stiffen. Like high blood pressure, the heart muscle can thicken when it has to work harder against increased pressure.
Coronary artery disease: Blockages in the heart’s blood vessels allow less blood to flow through your heart than usual. Very low blood flow to the heart can lead to the death of heart muscle cells (ischemia), preventing the heart from relaxing and filling as it normally would.
Pericardial disease: Fluid around the heart (pericardial tamponade) or a thickened outer covering on the heart (pericardial constriction) can limit the heart’s ability to fill with blood.
Other heart conditions: Several other heart conditions can cause the left ventricle to thicken, compromising its ability to relax and fill with blood. Aortic stenosis (narrowing of the aortic valve) and hypertrophic cardiomyopathy (an inherited heart muscle disorder that leads to a very thickened left ventricular wall) are two examples.
Obesity: Increased fat padding around the heart causes the heart to have to work harder to pump.
Sedentary lifestyle: A lack of physical activity can put you at higher risk of high blood pressure, diabetes, coronary artery disease, and obesity—all of which contribute to diastolic heart failure.
Obstructive sleep apnea (OSA): OSA is characterized by partial or complete cessation of breathing during sleep. This leads to a complex set of changes in the body, including increases in blood pressure, diminished oxygen delivery to the heart, and increased sympathetic nervous system activity. As a result of these changes, there is a mismatch between oxygen supply and demand, which may predispose you to cardiac ischemia and arrhythmia, left ventricular hypertrophy, left ventricular enlargement, and both systolic and diastolic heart failure.
Hypertension, diabetes, obesity, and a sedentary lifestyle are preventable risk factors that you should be aware of whether you have heart failure or not.
The New York Heart Association classification system is the simplest and most widely used method to gauge symptom severity among people with heart failure.
Class I
No limitations of physical activity
No heart failure symptoms
Class II
Mild limitation of physical activity
Heart failure symptoms with significant exertion; comfortable at rest or with mild activity
Class III
Marked limitation of physical activity
Heart failure symptoms with mild exertion; only comfortable at rest
Class IV
Discomfort with any activity
Heart failure symptoms occur at rest
Diagnosis
Heart Failure With Preserved Ejection Fraction
A diagnosis of HFpEF is made based on your clinical history, physical examination, laboratory data, echocardiography, and when necessary, by cardiac catheterization.
To make a diagnosis of heart failure, a doctor needs to assess a patient for:
The clinical signs and symptoms of heart failure, and
Evidence of normal, or near-normal, left ventricular systolic heart function with an LV ejection fraction over 50%, and
An assessment of the heart’s diastolic characteristics with an echocardiogram.
An echocardiogram (or cardiac echo) is an ultrasound of the heart that can provide information on how the heart relaxes and fills with blood, also known as diastolic function, cardiac output, and the ejection fraction.
A diagnosis of diastolic heart dysfunction can also be measured invasively, using a catheter to measure the mean pulmonary capillary wedge pressure, or non-invasively, using doppler imaging techniques.
While HFpEF is a heterogeneous syndrome with multiple different conditions that contribute to the syndrome, high blood pressure, diabetes, and coronary artery disease are the biggest culprits.
Heart Failure With Reduced Ejection Fraction
The diagnostic workup for HFrEF includes an assessment of your clinical history, a physical examination, lab work, and an echocardiography assessment of LV structure and function.
If echocardiography is inconclusive, additional imaging tests might be considered, including:
Radionuclide scan
Cardiac catheterization
Magnetic resonance imaging (MRI)
Computed tomography (CT) scan and endomyocardial biopsy
Cardiopulmonary exercise testing
HFrEF is a clinical syndrome that is diagnosed based on your symptoms of edema, fatigue, and shortness of breath, plus evidence of reduced left ventricular pumping power and blood delivery, usually documented by a left ventricular ejection fraction (LVEF) equal to or less than 40% on echocardiography.
The signs of HFrEF on physical exam include elevated jugular venous pressure, pulmonary crepitation, and displaced apex beat—but they don’t have to be present to make a diagnosis.
Instead, as noted above, the diagnostic hallmark of HFrEF is LVEF equal to or less than 40%, according to both the European Society of Cardiology HF guidelines and the American College of Cardiology Foundation/American Heart Association Task Force on the management of HF.
Treatment
Left-sided heart failure is a progressive condition with no cure, but it can be managed. In most people, heart failure is a chronic condition that requires lifelong treatment. Most treatments are geared toward slowing the progression of heart failure and managing symptoms.
Treatment of left-sided heart failure depends on the type of heart failure. There is no one-size-fits-all approach to managing the condition. The treatment should take the whole person into account, not just the heart.
A sound treatment plan usually starts with controlling a patient’s blood pressure and relieving fluid overload, which can cause swelling or shortness of breath, as well as addressing the anticipated mental, emotional, and physical changes that a patient will experience.
Numerous randomized trials have shown the efficacy of using a diuretic, an ACE inhibitor or an angiotensin receptor blocker, and a beta-blocker. Most patients with HFrEF will benefit from being on these medications.
Treating the root cause of a patient’s heart failure is the key to slowing heart disease. Here are a few examples:
If the cause of your heart failure is a narrowed or leaky heart valve or an abnormal connection between heart chambers, surgery can often correct the problem.
If it is blockage of a coronary artery, drug treatment, surgery, or angioplasty with a coronary stent may be the answer.
Antihypertensive drugs can reduce and control high blood pressure.
Antibiotics can eliminate some infections.
Heart Failure With Preserved Ejection Fraction Treatment
Diuretics are a mainstay of HFpEF treatment, but the medication is only as effective as the changes that a person makes to their diet and overall lifestyle.
If you have HFpEF, your doctor will likely suggest that you follow a treatment regimen that includes a combination of diet and lifestyle changes, medicines, and sometimes a device to protect your heart from abnormal rhythms.
Diet and Lifestyle Changes
If you have heart failure, the following lifestyle changes may help you manage your symptoms:
Reducing your salt intake is especially important. Too much salt in your diet can cause fluid retention, which counteracts the drugs (diuretics) that increase water excretion and relieve fluid accumulation.
The efficacy of medication in the treatment of diastolic heart failure is inconclusive. Therefore, the best way to manage HFpEF is to treat its underlying cause, such as hypertension, diabetes, or coronary artery disease.
Diuretics and beta-blockers are commonly used to manage HF symptoms. They work by removing excess fluid from the body and slowing the heart and giving it more time to fill. The use of diuretics like ACE inhibitors, thiazides, and spironolactone have even been found to increase life expectancy.
Management by Stage
The American College of Cardiology and the American Heart Association (ACC/AHA) recommend that cardiologists manage heart failure by its stage.
Stage A includes managing heart failure risk factors like high blood pressure and high cholesterol. This may include putting you on a thiazide diuretic or ACE inhibitor and a statin.
Stage B is diastolic dysfunction without symptoms. In this case, your cardiologist will likely prescribe a thiazide diuretic, ACE inhibitor, or nondihydropyridine calcium channel blockers to help ease the load on your heart.
Stage C is symptomatic heart failure with or without hypertension. At this stage, your doctor will focus on treating the volume overload on your heart by using diuretics.
The ACC/AHA also recommends starting or continuing a combined endurance and resistance training program for patients with HFpEF to improve exercise capacity, physical functioning, and diastolic function. Exercise has been proven to help the heart work more efficiently.
Heart Failure With Reduced Ejection Fraction Treatment
Treatment for anyone with heart failure should start with lifestyle modification such as:
Diet modification, including low sodium and fluid intake
Smoking cessation
Decreased alcohol intake
Increased exercise
Maintaining a healthy weight
Pharmacotherapy is the cornerstone of the treatment of HFrEF. The main validated heart failure medications are:
Angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs): Proven to reduce mortality rates and improve kidney function
Beta-blockers: Proven to reduce mortality rates by decreasing strain on the heart
Diuretics: Includes drugs like thiazides, which not only reduce mortality, but also reduce congestive symptoms by removing fluid around the heart and lungs. Loop diuretics produce a more intense and shorter diuresis effect than thiazides.
Mineralocorticoid receptor antagonists (MRAs), such as spironolactone and eplerenone: Used when beta-blockers and ACE inhibitors fail. They should be used cautiously in those with kidney disease, as the medication can exacerbate renal dysfunction.
Digoxin: Has a high side effect profile and is used as a last-ditch effort to reduce hospitalization
Ivabradine: Works like a beta-blocker to slow the heart; often prescribed to those who cannot tolerate beta-blockers and used together with ACE inhibitors/ARBs or MRAs/ARBs
Medications are usually added based on how effective they are at managing your symptoms. Your cardiologist will likely start with a combination of an ACE inhibitor, beta-blocker, or diuretics for symptom relief. If you are still symptomatic and your LVEF is equal to or less than 35%, an MRA might be added.
If you are still symptomatic and your LVEF is equal to or less than 35%, your doctor may suggest replacing your ACE inhibitor with an angiotensin receptor-neprilysin inhibitor. Ivabradine or cardiac resynchronization therapy might also be considered.
Finally, if you are still asymptomatic, digoxin, an LV assist device, or heart transplantation should be considered.
Prognosis
There is no cure for left-sided heart failure, but timely management greatly increases your chances of living well with the condition.
Left-sided heart failure, whether HFpEF or HFrEF, is a progressive condition associated with increased mortality, even if you do not have symptoms.
The prognosis of left-sided heart failure depends on many factors, including:
Age
The extent of left-sided heart failure: There are four stages of heart failure, with each indicating how serious your condition is.
Prior medical conditions, like diabetes
Prior hospitalizations
How your body responds to medical treatments
Exercise intolerance
HFpEF Prognosis
The outlook for HFpEF is especially poor if you have been hospitalized, with one-year mortality rates as high as 25% among older patients, and five-year mortality rates of 24% for those over the age of 60 and 54% for those over 80.
Factors associated with a worse prognosis include higher levels of NT-proBNP, older age, diabetes, past history of heart attack or chronic obstructive pulmonary disease (COPD), reduced glomerular filtration rate and diastolic function, and right ventricular remodeling on cardiac echo.
HFrEF Prognosis
Diastolic heart failure tends to have a better short-term prognosis compared to systolic heart failure.
Normal ejection fraction rates range between 50% and 70%. Research shows that the severity of left ventricular dysfunction, measured by the ejection fraction, is proportional to increases in mortality rates.
In other words, the worse the left-sided heart failure, the worse the prognosis. In one trial, 50% of participants with an ejection fraction below 15% did not live for one year.
Survival rates in patients with heart failure are 75.9% at one year, 45.5% at five years, and 24.5% at 10 years, compared to 97%, 85%, and 75% in the general population, respectively.
Despite advances in medical technology, treatment, and widespread heart health campaigns, high mortality rates of 15% to 20% during the first year of diagnosis (and rising to 40% to 50% within five years of diagnosis) have remained relatively consistent in recent decades.
If you are over 65 years old, you are at a particularly high risk of heart disease. This underscores the need to start a heart-healthy life sooner rather than later. Research has shown that older patients hospitalized with congestive heart failure face a grave prognosis, particularly if their heart failure symptoms are caused by LV systolic dysfunction.
Coping
If you have heart failure, feelings of fear, anger, emotional distress, and depression may arise after the initial diagnosis. The physical limitations can be tough to accept, and you may not be ready to make all the changes that are asked of you. All these reactions are natural. Talking to friends and family can help you navigate these challenges.
From adapting to taking daily medication to making adjustments to your social life, living with heart failure is not easy. The key is to make lifestyle changes that lessen the chances of having heart failure exacerbations.
Stay in tune with your symptoms and contact a healthcare professional immediately if you sense that your condition is worsening.
Limiting your stress, quitting smoking, and exercising can benefit both your physical and mental health. Addressing your emotional well-being is key, because depression and anxiety may lead you to turn to ways of coping—like smoking, drinking alcohol, using substances, or making dietary choices that are not the best for your heart health—that could worsen your physical health.
If you are experiencing the following symptoms for two or more weeks, you might be suffering from depression:
Feeling sad
Not enjoying normal activities
Trouble concentrating
Fatigue
Withdrawal from friends and family
Feeling hopeless and worthless
Excessive sleepiness
Loss of appetite
Suicidal thoughts
Recognizing that you might be depressed is the first step to taking action. Talk to your doctor about what options you have for treatment. This might include seeing a mental health provider and working through your stress with methods like cognitive behavioral therapy or medication. Or you might find that staying active and communicating with your loved ones about how you are feeling is enough to manage your mental health.
A Word From Verywell
Learning that you have heart failure is scary, but the better you understand the signs and symptoms of the condition, the better prepared you will be to take steps that can prevent exacerbations.
The once grim prognosis for heart failure can now be well managed with a combination of lifestyle modifications and medical monitoring. For example, you might start following a low-sodium diet, taking medications, and having frequent check-ins with your cardiologist.
While having to make many lifestyle changes in a short time can seem daunting, leaning on your friends and family, reaching out to a mental healthcare professional, and taking part in support groups can help.
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Benign Prostatic Hyperplasia (BPH)
What is BPH disease?
The benign prostatic hyperplasia or BPH is the enlargement of the prostate gland. It is more common in men as their age progresses. You can then check information described by urologist in East Delhi about its causes, symptoms and treatment.
Causes and symptoms of benign prostatic hyperplasia
What is Benign Prostatic Hyperplasia (BPH)?
BPH is the non-cancerous growth of the prostate gland due to an increase in the number of cells in the gland. The large prostate is exceptional before age 40, however the enlargement increases with age and between 50 and 60 years, 50% of men present it. Many men raise their concern infront of the best urologist in East Delhi that is it cancer. But, It is not cancer, nor does it increase the risk of suffering it and its development is associated with the natural aging of the cells.
What are the symptoms of inflamed prostate?
The prostatic hyperplasia is clinically manifested called lower urinary tract symptoms (LUTS). These symptoms are divided into three groups.
Emptying symptoms
Weak, weak jetwith little torrent.
Slow urination. Some patients begin to be aware of this when they urinate in public places. They notice that the bathroom light goes out when they have not finished urinating, or when they notice that other people enter, urinate and leave, they are still urinating there.
Watering in the shower, the jet is not thin, it opens and inevitably stains the toilet lid.
Distressed urination. The patient begins urination and stops, starting again and cutting once or several times.
Delayed onset of urination. It takes to start urinating. Some patients describe it as if the urine came from far away.
Voiding effort. The patient instinctively makes some force to shorten the time of urination but sometimes does not, paradoxically, make it slower.
Increased terminal drip. The end of urination becomes a continuous drip, like a poorly closed tap.
Irritative filling symptoms
Urgency. It goes from not wanting to urinate, to have a pressing desire in a short space of time (in the path of an elevator, in a garage or in the car, forcing to stop to evacuate).
Increased urinary frequency. It starts to urinate often. There may come a time when the patient urinates before any action he is going to commit, however short it may be, a waiting line, a short drive, when entering a cinema, etc. so as not to be in a compromised situation later.
Urinary incontinence. Sometimes because it does not arrive on time, sometimes due to overflow.
Nocturia. He begins to get up at night to urinate, more and more times, losing quality of sleep and therefore of life.
Postmictional symptoms
Feeling of incomplete emptying.
Dripping postmiccional. Despite waiting a few seconds after finishing urinating and the patient has already dressed, there is a small and traitorous escape, which causes his underwear to get stained.
Urologist in Noida reminds that apart from benign prostatic hyperplasia, there are also other pathologies that give voiding symptoms and that can be confused with BPH such as the following:
Potomania
Ureteral lithiasis
Bladder tumor
Urethral stricture
Prostatitis
Foreign bodies in urethra and bladder
Urinary tract infections
Bladder neurogenic dysfunction
Detrusor muscle hypoactivity
Nocturnal polyuria
Detrusor hyperactivity, etc.
Screening and testing in patients with BPH
There is a degree of recommendation in all guides by the best urologist in Noidaregarding what diagnostic tests should be performed to diagnose inflammation of the prostate.
Recommended tests
A detailed medical history, with a physical examination that also includes a rectal examination, as well as an ultrasound and blood tests with PSA termination and finally a urinary sediment
Optional tests
Flowmetry, daily voiding, sexual function.
Treatment of benign prostatic hyperplasia
Frequently, the increase in prostate volume causes some problems or discomforts. Depending on the size of the prostate of the symptoms it generates and also on the characteristics of the person suffering from it, one or the other treatment will be established by urologist in Ghaziabad.
The treatment of benign prostatic hyperplasia less invasive is to prescribe oral medication, medications known as alpha blockers are used.
On the other hand, sometimes it is recommended by the best urologist in Ghaziabad to perform a surgical treatment. The surgical technique varies according to the prostate size, the age of the patient, the concomitant diseases, although it must also be taken into account, if the growth is of the whole prostate or only of the middle lobe, in addition to the mastery of each of the techniques by part of the urologist is an important factor. In general, in very large prostates open surgery is very effective and effective. On the contrary, in the small ones, there are different forms of transurethral resection (bipolar, laser, etc.) that also offer very good results.
When benign prostatic hyperplasia should be operated?
If the patient perceives that the symptoms produced by prostate growth, whether it is the difficulty in urinating, the frequency with which he urinates etc., worsen his quality of life.
When signs appear on the bladder -prostate ultrasound such as the significant increase in bladder thickness, the appearance of diverticula in the bladder or stones.
If recurrent urine infections arise despite treatment with correct oral medication.
Acute urinary retention is more frequent in patients with BPH. If these occur in an accidental way for example, triggered by an anesthesia a surgical intervention, It is not considered a criterion to perform the surgical operation of BPH. However, when the patient has already presented a couple of episodes of urinary retention if a criterion to be intervened will be considered.
Affects the intervention of benign prostate hypertrophy to sexual life
The interventions of benign prostate hypertrophy do not affect the erection, since they do not touch the nerves and vessels that participate in the erection mechanism. It is the same as the surgical technique is performed through the urethra or through open surgery.
The intervention of benign prostatic hypertrophy does affect ejaculation and although the patient has an orgasm of intense note, however, semen does not come out of his urethra. The semen in the prostate surgery is then mixed with the urine.
Finally, according to sexologist in Vaishali, the intervention also affects fertility, since no semen in sexual intercourse does not produce a pregnancy. However, sperm can be obtained by centrifugation of postcoital urine.
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