30 Apr, 2024

Get To Know Your Heart Health: A Clear Comparison of Echocardiogram vs ECG

When it comes to heart diagnostics, understanding the difference between an echocardiogram and ECG is crucial when comparing their distinct roles in cardiovascular health. Simply put, an echocardiogram offers a visual evaluation of the heart’s structure and motion, while an electrocardiogram (ECG) tracks the electrical activity dictating the heart’s rhythm. This article delves into how each test operates, their clinical indications, and the insights they provide, guiding you through the nuances of echocardiogram vs ECG.

Not sure what scan you need? Is an echocardiogram right for you? Speak to a member of our expert clinical team in a phone consultation for advice about which scan to select for your symptoms, or book a private echocardiogram online in minutes if you're ready to get started. 

Key Takeaways

  • Echocardiograms and Electrocardiograms (ECGs) are complementary, non-invasive diagnostic tools used to assess heart health, with echocardiograms focusing on heart structure using sound waves and ECGs on electrical activity using electrodes.

  • Echocardiograms are primarily used for detecting structural heart issues and conditions like atherosclerosis (build-up in the arteries) and valvular disease, while ECGs are crucial for diagnosing rhythm and electrical imbalances such as arrhythmias (abnormal rhythm of the heartbeat) and coronary heart disease.

  • Different types of echocardiograms and ECGs are available for specific diagnostic needs, including Transthoracic (external chest) and Transesophageal (internal via the throat) Echocardiograms for detailed imaging. Resting, Stress, and Ambulatory types of ECGs are available for assessing the heart’s electrical activity under various conditions. We'll dive into each of these in this guide.

Unraveling Echocardiogram and ECG

Echocardiograms and Electrocardiograms (ECGs) are versatile, non-invasive diagnostic tools that assess heart functionality. While they might sound similar, each has a unique role.

Echocardiograms use sound waves to produce live imaging of our heart’s structure, providing detailed visuals of the heart chambers, valves, and blood flow.

On the other hand, ECGs primarily focus on the heart’s electrical activity, recording the heart’s electrical impulses, which is helpful for diagnosing rhythm and electrical imbalances.

These tests offer complementary views of our heart’s health. Think of the heart as a team, with the ECG managing the electrical department and the echocardiogram overseeing the mechanical division. Together, they can give a comprehensive picture of heart health. But how do they perform their roles? Let’s take a closer look.

Echocardiogram: A Glimpse into Heart Structure

The echocardiogram uses an ultrasound probe to emit high-frequency sound waves, creating detailed images of the heart and blood vessels, allowing doctors to assess their structure and function. This type of ultrasound scan provides valuable information for diagnosing and managing heart conditions. It’s like a window into your beating heart in real-time, providing detailed visuals of heart structure, including the sizes of the heart chambers, the function of the valves, and how well the heart is pumping blood.

The beauty of an echocardiogram lies in its:

  • Non-invasive nature

  • Accessibility and affordability

  • Ability to provide a wealth of information

  • Diagnosis of a variety of heart conditions, including atherosclerosis, congenital heart defects, and heart failure

  • Ability to help doctors understand the cause of heart murmurs and prescribe the right treatment

ECG: Tracking the Heart's Electrical Activity

Unlike echocardiograms, which use sound waves, an Electrocardiogram (ECG) records the electrical activity of the heart. This non-invasive test helps doctors determine the heart’s electrical imbalances, if any. Small adhesive pads are attached to the chest and limbs, which allows for monitoring, tracking, and documenting the heart’s electrical impulses.

ECGs are commonly used for routine check-ups and diagnosing arrhythmias (abnormal heartbeats), playing a pivotal role in monitoring and assessing heart health. They help doctors understand your heart's rhythm, and identify any potential electrical issues.

Situations Requiring Echocardiogram and ECG

Now, let’s explore when these tests are typically ordered. Echocardiograms are often required when signs and symptoms indicative of heart disease are observed. Think of it as an investigative tool for heart health.

On the other hand, ECGs are typically used to investigate symptoms like chest pain, palpitations, and shortness of breath.

Echocardiogram Indications

Echocardiograms are like detectives, investigating the intricate workings of the heart. They are specifically ordered when signs and symptoms indicative of heart disease are occurring. Echocardiograms can provide a wealth of information that can help diagnose potential heart conditions, including details of your:

  • Chamber sizes

  • Valve functions

  • Blood flow patterns

  • Heart muscle thickness

  • Heart wall motion abnormalities

This investigative tool can detect a range of heart conditions, such as atherosclerosis (build-up in the arteries), cardiomyopathy (heart muscle diseases), and congenital heart defects (present since birth), among others. For instance, if you have heart murmurs, your doctor would likely recommend an echocardiogram to determine the cause.

ECG Indications

ECGs, on the other hand, are like the heart’s personal biographer, recording its electrical activity and helping diagnose and monitor heart-related conditions. These tests are typically ordered when symptoms occur such as:

  • chest pain

  • heart palpitations

  • shortness of breath

  • dizziness

Moreover, symptoms of a blocked artery, such as weakness and nausea, can also be evaluated through an ECG. The identification of these symptoms and the subsequent performance of an ECG are critical for timely and accurate assessment of heart health, as they may indicate the presence of blood clots or even a heart attack.

Types of Echocardiograms and ECGs

The world of Echocardiograms and ECGs is vast, and they come in different forms to serve specific health information needs. From Transthoracic Echocardiogram (TTE) and Transoesophageal Echocardiogram (TEE) to Stress Echocardiogram and Foetal Echocardiogram, the type of echocardiogram prescribed depends on the specific health information required. Similarly, ECGs vary from Resting ECG, Stress ECG to Ambulatory ECG tests.

Let’s delve deeper into these types.

Echocardiogram Varieties

Among the types of echocardiograms, the Transthoracic Echocardiogram (TTE) is the most common echo test. It uses an ultrasound from outside the body to examine heart function and blood flow. On the other hand, the Transoesophageal Echocardiogram (TEE) provides high-resolution images from inside the oesophagus, especially handy when TTE results are not clear.

Stress Echocardiograms capture heart images before and after exertion, such as using a treadmill or exercise bike, helping detect abnormalities or coronary artery problems related to coronary artery disease.

For the little ones not yet born, Foetal echocardiograms are specialised ultrasound tests conducted during pregnancy to check the developing baby’s heart structure and function.

ECG Test Options

Just like echocardiograms, ECGs also come in different types. Resting ECG tests the heart’s electrical activity and detects abnormalities by placing electrodes on specific areas of the chest, arms, and legs. Stress ECG, on the other hand, evaluates how the heart responds to increased stress, typically performed to look for changes in heart activity during exercise or activities.

The Ambulatory ECG records heart activity continuously as the individual goes about daily tasks, providing a longer-term view of the heart’s rhythm. A special form of this is the Holter Monitor, used specifically for detecting heart rhythm disorders such as atrial fibrillation, ventricular tachycardia, and irregular heartbeat over an extended time, typically 24-48 hours.

Procedures: How Echocardiograms and ECGs are Performed

Now that we’ve explored the what and why of echocardiograms and ECGs, let’s look at the how. The procedure for both tests is non-invasive and relatively quick, with the echocardiogram typically taking about 20 minutes and the ECG test much quicker, usually taking about 3 minutes to complete,.

Performing an echocardiogram (echo) test

An echocardiogram is a type of ultrasound scan, which involves minimal prior preparation. The most common type is a transthoracic echocardiogram (TTE).

You'll be asked to remove your clothing from the waist up, and will usually be given a hospital gown to cover yourself.

During the scan, sticky electrodes will be placed on your chest, and you'll be asked to lie down on a couch. Then, a lubricating gel will be applied to the transducer (scanning probe), and/or to your skin.

The scanning technician will then move the scanning probe over the skin of your chest, and images will appear on the computer connected to the scanner. You may hear a whooshing sound during the scan.

The test usually is completed within 20 minutes, and you can return to your day as normal afterwards.

Performing an ECG Test

The ECG test might be short, but it provides a wealth of information. This medical procedure involves placing adhesive pads on the patient’s chest. These pads are connected to the ECG machine, which records the heart’s electrical activity.

While the process may sound technical, it’s quite straightforward and usually takes between 5 to 10 minutes to complete. The recording from an ECG provides detailed information about the electrical activity and rhythms of the heart, which can help in diagnosing various heart conditions.

Interpreting Results: What Echocardiograms and ECGs Reveal

Now we reach the crucial part - interpreting the results. Both echocardiograms and ECGs can reveal a wealth of information about your heart health. Echocardiograms provide a detailed look at the heart’s structure, including muscle, chambers, and valves.

ECGs, on the other hand, capture the electrical activity of the heart and can detect arrhythmias, heart blockages, and prior heart attacks, while echo detect heart blockage through sound waves.

Echocardiogram Insights

Echocardiograms provide a wealth of information about heart structures and functions. From assessing chamber size to wall thickness and valve operation, the test can provide detailed insights using sound waves. Advanced technologies like three-dimensional echocardiography offer more detailed images for an in-depth evaluation of heart function.

The results are then interpreted by your healthcare provider. Terms like left ventricular systolic dysfunction (LVSD) and ejection fraction (EF) are used to convey the heart’s pumping strength and capacity. Doppler echocardiography and colour flow imaging techniques aid in diagnosing blocked or leaking valves and assessing arterial blood pressure.

Regular follow-ups may be required to monitor changes in heart function, especially for patients with diagnosed heart failure or valvular disease.

ECG Findings

In contrast, ECGs play a crucial role in monitoring the heart’s rate and rhythm, helping diagnose arrhythmias, coronary heart disease, and cardiomyopathy. Patterns analysed in ECG results can indicate coronary heart disease and, specifically, myocardial infarction, often known as heart attacks.

While an abnormal ECG does not always mean there is a heart condition, its findings contribute to better predictive models for cardiac events, especially when used alongside echocardiography data.

Echocardiogram vs ECG: Complementary Diagnostic Tools

Now that we understand Echocardiograms and ECGs better, it’s essential to note that it’s not a matter of Echocardiogram vs ECG. Instead, these two diagnostic tools complement each other, providing a comprehensive view of heart health. They’re like two sides of the same coin, with each focusing on different aspects of heart functionality.

ECGs excel at recording the heart’s electrical activity, helping diagnose electrical imbalances and heart rhythm disorders. Echocardiograms, on the other hand, shine in providing a detailed look at the heart’s structure, including heart chambers and valves. Together, they can help healthcare providers make accurate diagnoses and guide treatment plans.

In the end, both Echocardiograms and ECGs play a pivotal role in maintaining and monitoring heart health. They’re not substitutes for each other but rather, they’re two halves of a whole, working together to keep your heart beating strong.


In conclusion, both Echocardiograms and ECGs are essential tools in the diagnosis and management of heart conditions. While Echocardiograms use sound waves to provide a detailed view of the heart’s structure and functions, ECGs record the heart’s electrical activity, helping diagnose rhythm and electrical imbalances.

Understanding these tests can empower you to take charge of your heart health. Whether you’ve been recommended an ECG or an echocardiogram, remember, both tests serve the same goal - to ensure your heart’s well-being.

Frequently Asked Questions

How do Echocardiograms and ECGs differ?

Echocardiograms provide detailed visuals of the heart's structure and functions using sound waves, while ECGs record the heart's electrical activity to diagnose rhythm and electrical imbalances.

When are Echocardiograms and ECGs typically ordered?

Echocardiograms are typically ordered when signs and symptoms of heart disease are observed, while ECGs are ordered to investigate symptoms like chest pain, palpitations, and shortness of breath.

What are the different types of Echocardiograms and ECGs?

There are different types of Echocardiograms, such as Transthoracic Echocardiogram (TTE), Transoesophageal Echocardiogram (TEE), Stress Echocardiogram, and Foetal Echocardiogram, as well as ECGs, which include Resting ECG, Stress ECG, and Ambulatory ECG tests.

How are Echocardiograms and ECGs performed?

Echocardiograms involve using an ultrasound probe on the chest, while ECG tests require placing adhesive pads on the chest, arms, and legs to record the heart's electrical activity.

What can Echocardiograms and ECGs reveal about heart health?

Echocardiograms offer insights into the heart's structure, while ECGs can detect electrical irregularities and previous heart events, such as arrhythmias and blockages. Both tests play a crucial role in assessing overall heart health.

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