Understanding heart failure
Heart failure comes in more than one form: sometimes the heart muscle has weakened and ejects less blood with each beat, and sometimes the muscle has stiffened so the heart fills under higher pressure even though its squeeze looks preserved. The two patterns are managed differently, which is why the first job is a precise picture — usually from an echocardiogram, an ECG, and blood tests.
The encouraging part of modern heart-failure care is how much of it works. Today's guideline-directed medications, introduced and increased step by step, protect the heart over years — but they only work at doses patients actually reach, which takes patient, structured follow-up. That cadence of visits, checks, and adjustments is the core of what this practice does.
What you might notice
Symptoms that commonly bring heart failure to light:
- Breathlessness with activity, or when lying flat
- Waking at night short of breath
- Swelling in the ankles and legs that builds through the day
- Rapid weight gain over days
- Deep fatigue out of proportion to effort
How we evaluate it
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Echocardiogram
The central test — it shows how the heart squeezes, fills, and how its valves are working.
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Blood tests
Including markers of heart strain, kidney function, and iron studies that shape medication choices.
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ECG and rhythm monitoring
Rhythm problems and heart failure frequently travel together, and each worsens the other.
Every test above is described — prep included — on the diagnostics & testing page.
How we manage it
Medication is the foundation: the modern combination of heart-failure therapies, started low and built deliberately toward the doses shown to protect the heart. Every step is explained — what each medication is for, what to expect, and what we're watching in your labs.
Just as important is the daily rhythm between visits: a morning-weight routine with a written action plan for early warning signs, practical sodium and fluid guidance, vaccination review, and a referral to cardiac rehabilitation when appropriate. If a hospital stay happens, Dr. Marsh coordinates with the Lakemont General team and sees you in the office within days of discharge — the window where careful follow-through matters most.