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Echocardiogram vs ECG, what’s the difference?
If you've been referred for an echocardiogram (echo) or an electrocardiogram (ECG), it's easy to feel confused. Although both tests are used to assess your heart, they work in very different ways and provide different information. Dr Oliver Segal, Consultant Cardiologist & Electrophysiologist, explains what each test involves, the key differences between them, and when your doctor may recommend one or both tests.
What is an echocardiogram?
An echocardiogram, also called a heart scan or simply an "echo", is a safe, non-invasive ultrasound scan that allows doctors to see your heart in action. It uses sound waves to create detailed images of the heart, helping specialists assess its structure and how well it is working. Unlike an X-ray, an echo does not use radiation.
The test shows the size and shape of the heart, how effectively it pumps blood, the condition of the heart valves and whether there are any abnormalities affecting the heart muscle.
What is an ECG (electrocardiogram)?
An electrocardiogram, commonly known as an ECG, is a quick, safe and painless test that records the electrical activity of your heart using small sensors called electrodes placed on the skin. The test measures the electrical signals that control your heartbeat, allowing doctors to assess how fast your heart is beating and whether it is beating in a regular rhythm.
Unlike an echocardiogram, an ECG does not create images of the heart, but it can help identify abnormal heart rhythms (arrhythmias), signs of a previous heart attack and other changes in the heart's electrical activity that may indicate an underlying heart condition.
You may see the terms ECG and EKG used interchangeably. They refer to the same test - ECG is the British English standard and EKG is from the German/American spelling.
What is the difference between an echocardiogram and an ECG?
Although an echo and an ECG are both commonly used to assess heart health, they provide different types of information about your heart.
An echo uses ultrasound technology to create moving images of the heart, whereas an ECG records the heart's electrical activity using electrodes placed on the skin.
Echocardiogram vs ECG: key differences
| Echo | ECG |
| Uses ultrasound (sound waves) | Uses electrodes placed on the skin |
| Produces images of the heart | Records the heart's electrical activity |
| Shows the heart's structure and movement | Shows heart rate and rhythm |
| Assesses pumping function, valves and blood flow | Helps identify arrhythmias and signs of previous heart damage |
| Typically takes 20-30 minutes | Typically takes around 5 minutes |
Is an echocardiogram the same as an ECG?
No, an echo and an ECG are different tests that provide different information about your heart. An echo creates images of the heart's structure and movement, while an ECG records the electrical activity that controls your heartbeat. Both tests are used to assess heart health, and your doctor may recommend one or both depending on your symptoms and medical history.
In many cases an ECG is the first test a cardiologist will arrange, as it is quick, non-invasive and provides immediate information.
“An ECG tells us how the heart is beating electrically, while an echocardiogram shows us how the heart looks and works mechanically. Because these tests provide different but complementary information, many patients will have both as part of their cardiac assessment.”
What about other types of ECG?
In some cases, your cardiologist may recommend a wearable ECG monitor rather than a standard ECG performed in hospital or a clinic. These devices record your heart's electrical activity over a longer period, helping to detect intermittent symptoms that may not occur during a routine test.
Common types include Holter monitors, which are worn continuously for 24 to 48 hours or longer, and other ambulatory ECG monitors that can record heart activity over several days or weeks, such as Zio patch monitors.
Worried about your heart?
Book an appointment with Dr Oliver Segal today