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Exploring ECG vs. Echocardiogram Tests: Unraveling Cardiac Diagnostics | Max Hospital

ECG and ECHO Tests: Understanding the Difference

By Dr. Sanjat Chiwane in Cardiac Sciences , Cardiology , Interventional Cardiology

Mar 18 , 2024 | 9 min read

Electrocardiography (ECG) and Echocardiography (ECHO) are two non-invasive and painless medical tests used by cardiac specialists to assess the heart's functionality. Unlike many medical procedures, these tests need no specific preparation from patients and pose minimal risks. In this article, we will delve into the difference between ECG and ECHO procedures, shedding light on their importance in diagnosing heart-related issues.

What is ECG/Electrocardiogram? 

An electrocardiogram (often called EKG or ECG) involves the use of temporary electrodes placed on the patient's chest and limbs to monitor, track, and document the electrical activity of the heart. The ECG test entails a computer translating the collected information into a wave pattern that the healthcare provider can interpret. It is a quick, noninvasive test that causes no discomfort. 

Types of ECG/Electrocardiogram Tests 

Electrocardiogram (ECG) tests come in various types, each designed for specific diagnostic purposes. These specialised ECG tests can help detect various heart conditions, including myocardial infarction (heart attack) and heart block. ECG types include:

Resting ECG

A resting ECG is typically performed while the individual is relaxed and comfortable. They are asked to lie down, and electrodes are placed on specific areas of their chest, arms, and legs. This test captures the heart's electrical activity at rest, providing a baseline measurement of the heart's health. It's a routine test used for various purposes, including routine check-ups and assessing symptoms like chest pain or palpitations.

Stress ECG

Also known as a treadmill test or exercise ECG, the stress ECG involves monitoring an individual's heart while they engage in physical activity, typically on a treadmill. The purpose of the stress ECG is to evaluate how the heart responds to increased stress, such as exercise. It's a valuable tool for assessing cardiac fitness, diagnosing heart disease, and determining safe exercise levels for those with certain medical conditions.

Ambulatory ECG

This test is useful for detecting irregular heart rhythms or other cardiac issues that might not show up during a short-term test. The device records the individual's heart activity continuously as they go about their daily tasks, offering a more detailed view of their heart's health.

There are also ECGs focused on particular conditions like ECG Brugada syndrome.

Need for ECG Test

Some common situations where an ECG is typically done include:

  • Arrhythmias (Abnormal Heart Rhythm): When a patient experiences irregular heart rhythms, which can include tachycardia (fast heart rate) or bradycardia (slow heart rate), an ECG can help diagnose and monitor these conditions.
  • Coronary Artery Disease (CAD): If a patient exhibits symptoms such as chest pain or has a history of heart attacks, an ECG can be recommended. CAD occurs when the arteries supplying blood to the heart become narrowed or blocked.
  • Previous History of Heart Attack: Individuals who have previously suffered a heart attack may require regular ECGs as part of ongoing cardiac care to monitor for any signs of recurrent issues.
  • Monitoring Devices such as a Pacemaker: Patients with implanted devices like pacemakers or implantable cardioverter-defibrillators (ICDs) may need ECGs to assess the functioning of the devices and ensure they are effectively regulating the heart's rhythm.
  • Chest Pain: Chest pain should not be ignored, regardless of its intensity or duration. It's a common reason for undergoing an ECG to help identify potential cardiac issues.
  • Feeling Low Energy While Exercising: If you experience a sudden decrease in energy or stamina during physical activity, it's essential to investigate the cause. An ECG can help determine whether an underlying cardiac condition is contributing to the fatigue.

Read About: New Generation Pacemakers Cost

How is the ECG Test Done? 

An ECG involves several steps and typically takes about 5-10 minutes to complete. During the procedure, a trained technician uses 10-12 small adhesive pads placed at various locations on the patient's chest.

These adhesive pads serve as contact points for the leads of the ECG machine. The leads play a crucial role in transmitting data related to the heart's electrical activity. This data is then used to generate a tracing, often referred to as an ECG or EKG strip, which provides valuable insights into the patient's heart health.

An ECG test is helpful when a patient presents specific symptoms indicative of a heart condition. The diagnostic tool assists cardiac specialists in assessing the heart's functioning by recording its electrical signals. While an ECG itself cannot directly detect a stroke, it can help identify arrhythmias or other cardiac issues that may be associated with a stroke. It's important to note that even with a blockage, an ECG can appear normal, depending on the blockage's location and severity.

What is an ECHO/Echocardiogram Test? 

Echocardiography, often referred to as an echocardiogram or echo test, is a medical imaging procedure that utilises sound waves to create detailed images of the heart. These images serve as valuable resources for cardiac surgeons, aiding in the detection and evaluation of various heart diseases and related conditions. It's important to note that in certain clinical scenarios, an echo test may be necessary, even if the results of an ECG (Electrocardiogram) are normal.

Types of ECHO/Echocardiogram Tests  

There are several types of echocardiograms, including:

Transthoracic Echocardiogram (TTE)

A standard noninvasive medical procedure used to assess heart and valve function involves creating external images of the heart. In some cases, contrast dye can be used to enhance visibility during this diagnostic test.

Transesophageal Echocardiogram (TEE)

Transesophageal echocardiography (TEE) is a medical procedure that offers an in-depth view of the heart and aorta by generating internal images. This advanced imaging technique is recommended when standard echocardiograms fall short in providing the necessary level of detail.

Foetal Echocardiogram

Noninvasive prenatal testing (NIPT) is a procedure used to assess the health of a developing baby's heart. It involves scanning the pregnant person's belly using an ultrasound wand. This safe and painless test allows healthcare providers to monitor the baby's cardiac development and ensure the overall well-being of both the baby and the mother during pregnancy.

Stress Echocardiogram

Cardiac stress testing is a diagnostic procedure that assesses how the heart responds to physical activity or stress. This test is commonly used to detect and diagnose coronary artery disease (CAD). In some cases, when exercise is not an option, medication can be used as a substitute to simulate the effects of physical activity on the heart.

Need for an ECHO Test

Echocardiography (ECHO) is a powerful diagnostic tool. Specific symptoms can prompt a recommendation for this test:

Heart Murmurs

When an unusual sound, called heart murmurs, is heard during a heartbeat, it might prompt a recommendation for an Echocardiogram (ECHO) to thoroughly examine the heart's valves and chambers.

Swollen Legs or Feet

Edema or swelling in the legs or feet might be indicative of an issue with the heart's pumping ability. In such cases, an Echocardiogram (ECHO) can provide valuable insights.

Dizziness or Fainting

Experiencing dizziness or fainting episodes can be concerning, and they could be signs of various heart conditions. An Echocardiogram (ECHO) is a vital tool in assessing cardiac health and pinpointing the causes of these symptoms.

Shortness of Breath

Shortness of breath, often accompanied by chest discomfort, can be a sign of various heart conditions. An Echocardiogram (ECHO) can be instrumental in identifying the underlying cause of this symptom.

Weakness or Fatigue

Unexplained weakness or extreme fatigue can be early signs of the heart not functioning optimally. When these symptoms arise, it is essential to consider an ECHO to assess the overall health of the heart and detect potential issues.

How is the ECHO/Echocardiogram Test Done? 

An echocardiogram is a diagnostic medical test performed by an experienced cardiac sonographer. This comprehensive examination typically takes about 20 minutes, including a 5-minute preparation period and a 15-minute procedure.

The procedure commences with the patient wearing a specialised gown and reclining on an examination table designed for electrocardiograms (ECGs). Patients are requested to lie on their left side to ensure optimal image acquisition. A conductive gel is applied to specific areas of the chest wall. The cardiac sonographer then meticulously positions an ultrasound probe to capture essential images for further analysis.

Electrocardiogram vs Echocardiogram

When assessing heart health, two common tests are the ECG (Electrocardiogram) and the ECHO (Echocardiogram). These tests offer essential insights into heart function, although they serve different purposes. Know the difference between ECG and ECHO. 

 

ECG 

ECHO 

Purpose

Detects arrhythmias, coronary heart disease, heart attacks, and cardiomyopathy.

Detects problems in the pericardium, issues with large heart blood vessels, blood clots inside the heart, and abnormal holes within the heart.

Technique

Records the heart's electrical activity by attaching painless electrodes.

Creates images of the beating heart using ultrasound.

Uses

Records the heart's electrical activity, including heart rate and rhythm.

Provides information about the heart's size, shape, pumping capacity, location and extent of tissue damage, internal heart chambers, valve functioning, and blood flow.

Application

Often used for routine check-ups, diagnosing arrhythmias, and monitoring heart health.

Used for diagnosing structural heart problems, evaluating valve function, and assessing heart conditions such as cardiomyopathy and pericardial disease.

Invasiveness

Non-invasive and painless procedure involving electrode placement on the skin's surface.

Non-invasive; no need for surgical incisions or insertion of devices.

Preparation

Requires minimal preparation; electrodes are attached to the chest, arms, and legs.

Can require fasting for a few hours before the test, especially if detailed images of the heart are needed.

Duration

Typically a short test, lasting a few minutes.

Can take longer, depending on the level of detail required; usually 30 minutes to an hour.

Results

Provides immediate results on the heart's electrical activity.

Images are reviewed by a specialist, and results are usually available after analysis.

Follow-up Tests

Often used as a preliminary test; further tests may be required based on ECG findings.

Usually followed by other imaging tests or clinical evaluations to confirm specific diagnoses.

Cost

Generally less expensive compared to ECHO.

Can be more expensive due to the use of specialised equipment and expertise.

Conclusion 

While both ECG and ECHO play pivotal roles in cardiac diagnostics, they offer distinct perspectives on the heart's functioning. ECGs shed light on the electrical aspects, whereas ECHOs provide a detailed insight into its mechanical performance. The harmonious integration of these diagnostic tools empowers healthcare professionals to make more informed decisions in research and the development of personalised treatment plans, ultimately enhancing the care and well-being of individuals with heart-related conditions.

Frequently Asked Questions

Q: Is an ECG necessary if the echo is normal?

A: The necessity of an ECG depends on the doctor's evaluation and the patient's specific condition.

Q: Can an echo detect heart blockage?

A: Echocardiography is not designed to detect blockages in the heart's arteries.

Q: What is the most effective test for heart blockage?

A: A CT scan is one of the most effective diagnostic tests for detecting heart blockages.

Q: What are the symptoms of a blocked artery?

A: Symptoms of a blocked artery may include chest pain, shortness of breath, heart palpitations, weakness, dizziness, and nausea. It's essential to consult a healthcare professional for a thorough evaluation.

Q: What vitamin can help with arterial plaque?

A: Vitamin B3 (niacin) is believed to have some potential benefits for heart health, but it should not be considered a sole treatment for removing arterial plaque. Consult with a healthcare provider for proper guidance on managing plaque buildup.

Q: Can an echo detect angina?

A: An echocardiogram is primarily used to assess the heart's structure and function and may not directly detect angina. To diagnose angina, an electrocardiogram (ECG) and clinical evaluation are typically employed.