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Difference Between ECG and Echo Explained

Know what, who and why of ECG & ECHO. Learn the key differences between them and lifestyle tips for a healthy heart.

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Written by Dr. Siri Nallapu

Reviewed by Dr. Shaik Abdul Kalam MD (Physician)

Last updated on 2nd Aug, 2025

Introduction

When it comes to heart health, doctors often recommend tests like ECG (Electrocardiogram) and Echo (Echocardiogram). Both help assess heart function, but they serve different purposes. This article will give the information, helping you understand why and when they are needed.

What is an ECG?

An ECG (Electrocardiogram) is a quick, painless test that records the electrical activity of your heart. It shows how fast your heart is beating and whether its rhythm is steady or irregular.

How is an ECG Done?

  1. Small sticky patches (electrodes) are placed on your chest, arms, and legs.

  2. These electrodes detect electrical signals from your heart.

  3. The test takes just a few minutes and is completely non-invasive.

Why is an ECG Done?

An ECG helps detect:

  1. Irregular heartbeats (arrhythmias)

  2. Heart attacks (past or present)

  3. Poor blood flow to the heart

  4. Enlarged heart chambers

Limitations of ECG

While useful, an ECG only provides a snapshot of heart activity at that moment. It doesn’t show structural problems like valve defects or heart muscle weakness.

What is an Echo?

An Echo (Echocardiogram) is an ultrasound of the heart. It uses sound waves to create moving images of your heart, showing its size, shape, and how well it pumps blood.

How is an Echo Done?

  1. A technician applies gel on your chest and moves a handheld device (transducer) over it.

  2. Sound waves create real-time images of your heart on a screen.

  3. The test is painless and usually takes 30-60 minutes.

Why is an Echo Done?

An Echo helps diagnose:

  • Heart valve problems (leaky or narrow valves)

  • Weak or thickened heart muscles

  • Congenital heart defects

  • Fluid around the heart (pericardial effusion)

Limitations of Echo

While detailed, an Echo doesn’t measure electrical activity like an ECG does.

Key Differences Between ECG and Echo

FeatureECG Echo 
PurposeMeasures electrical activityShows heart structure & function
How it WorksElectrodes detect heart signalsUltrasound creates heart images
Duration5-10 minutes30-60 minutes
Detectsheart attacks Valve defects, muscle weakness
Pain LevelPainlessPainless

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When Do You Need an ECG vs. an Echo?

You May Need an ECG If:

  1. You have chest pain or palpitations.

  2. You feel dizzy or faint often.

  3. Your doctor suspects a heart attack.

You May Need an Echo If:

  1. You have symptoms like shortness of breath or swelling in your legs.

  2. Your doctor hears a heart murmur.

  3. You have a history of heart disease.

Sometimes, both tests are needed for a complete heart evaluation.

Tips for a Healthy Heart

Whether you’ve had an ECG, Echo, or just want to keep your heart strong, these tips help:

  • Eat a balanced diet – Include fruits, vegetables, whole grains, and lean proteins.

  • Exercise regularly – Aim for 30 minutes of walking or cycling daily.

  • Avoid smoking & limit alcohol – Both can harm your heart.

  • Manage stress – Practice yoga, meditation, or deep breathing.

  • Monitor blood pressure & cholesterol – High levels increase heart risks.

When to See a Doctor?

If you experience:

- Chest pain or pressure

- Severe shortness of breath

- Irregular heartbeat

- Unexplained fatigue

Consult a doctor immediately. Early detection can prevent serious complications.

Final Thoughts

Both ECG and Echo are essential for heart diagnosis but serve different purposes. While an ECG checks electrical activity, an Echo examines heart structure. Your doctor will decide which test you need based on symptoms.

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Get Your Symptoms Assessed by cardiologist

Dr. M Sudhakar Rao, Cardiologist

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Cardiologist

10 Years • MD, DM, FACC, FESC, FSCAI

Bangalore

Apollo Clinic Bellandur, Bangalore

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11 Years • MBBS, MD (Gen Med), DM (Cardiology) AFAPSIC, FIMSA, FSCAI

Chennai

Apollo Hospitals Greams Road, Chennai

recommendation

95%

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