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Home / Tests & Investigations / Echocardiogram vs. EKG – Explained By A Cardiologist

Echocardiogram vs. EKG – Explained By A Cardiologist

December 10, 2017 by Dr. Mustafa Ahmed 31 Comments

Echocardiogram vs. EKG – What Are They?

When considering echocardiogram vs. EKG its important to have a basic understanding of both tests. Both the echocardiogram and EKG are very important and are commonly used heart tests that are instrumental in diagnosing various forms of heart disease. The echocardiogram is an ultrasound of the heart that provides moving pictures and provides information on the structure and function of the heart. The EKG is a heart tracing that mainly provides information on the rhythm of the heart. Both tests are often used in conjunction and are complimentary to each other.

EKG heart tracing

EKG heart tracing

echocardiogram heart scan

echocardiogram heart scan

Echocardiogram vs. EKG – Other Names

Echocardiogram is also known as an ultrasound scan of the heart, an echo, or sonar of the heart. EKG is also known as an ECG, a 12 lead EKG, or an electrocardiogram.

Echocardiogram vs. EKG – Both Are Considered Non-invasive

Below we discuss the differences in performing an echocardiogram vs. EKG. Both of these tests are considered non-invasive cardiac testing. Patients are not expected to feel any pain from either test. This is in contrast to invasive tests such as heart catheterization.

Echocardiogram vs. EKG – When Are They Ordered?

The EKG is the most commonly ordered heart test. Basically every patient every evaluated for a heart related issue or heart related symptoms get an EKG. The echocardiogram is also very commonly used but not as common as the EKG. The EKG can also be considered a screening test that is done in almost everyone that has a history and physical. The echo is more specifically ordered when there are signs and symptoms of heart disease present.

Echocardiogram vs. EKG – How Are They Done?

EKG – 10 small sticky pads on various places on the chest wall then leads from the EKG machine are attached. These leads transmit data that use the electrical activity of the heart to generate a tracing. For some men, chest hair may need to be shaved in places to improve contact and ensure a good tracing.

Echocardiogram – Patients are given a gown to wear and lie on a table specifically designed to perform the echocardiogram. Patients will typically lie on their left hand side. Ultrasound gel is applied to various areas of the chest wall then the ultrasound probe placed on the chest and the pictures taken.

Echocardiogram vs. EKG – How Long Do They Take?

EKG – The test itself takes about 5 minutes. Most of that is applying the leads; the tracing itself takes seconds to generate only.

Echocardiogram – In most cases about 20 minutes is needed to complete the test. 5 minutes of that is likely spent in preparation and 15 minutes used to take the pictures. In some cases depending on the specific information required the test can take longer.

Echocardiogram vs. EKG – What Information Do They Provide?

The EKG is a heart tracing. It provides information on the rhythm and rate of the heart. Outside of heart rhythm disorders, abnormal heart tracings can point towards various disease states. Hearth rhythm disordered may include fast heart rate (tachycardia), low heart rate (bradycardia), heart blocks; irregular heart beats (atrial fibrillation). In addition it can provide clues regarding enlargement of heart chambers and heart muscle abnormalities. An extremely important use of the EKG heart tracing is in the evaluation of suspected heart attacks. The EKG is the emergent test of choice in patients with chest pain.

The echocardiogram is an ultrasound scan of the heart that shows moving pictures that show the structure and function of the heart. It shows accurate information on the heart pumping function and heart chamber sizes. For this reason they are a valuable test in the evaluation of heart failure. Echocardiograms also provide highly accurate information on heart valve function. They can be used to identify leaky or tight heart valves. While the EKG can provide clues to many of these diagnoses, the echocardiogram is considered much more accurate for heart structure and function.

Echocardiogram vs. EKG – They Complement Each Other

Importantly in most cases of an abnormal EKG an echo will be ordered. For example if a patient presents with palpitations and an irregular heart tracing is picked up, the patient will be sent for an echocardiogram also to evaluate for underlying structural of functional disorders that may be the cause of the rhythm. If a patient has chest pain and the EKG suggests a possible heart attack or blockage, an echocardiogram will likely be ordered to see the extent of the damage. Hopefully this article has helped to explain echocardiogram vs. EKG.

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Comments

  1. Stuart BILYARD says

    January 17, 2018 at 10:29 pm

    I’m 54 male with 48pm on ECG it says abnormal ? Due to voltage can you explain what this means do I need to worry ?

    Reply
    • Dr. Mustafa Ahmed says

      January 28, 2018 at 5:41 am

      Have a healthcare provider glance at the EKG and interpret it. Machine reads are often useless and shouldn’t cause concern in isolation.

      you can follow my twitter at @MustafaAhmedMD

      Reply
    • Arthur says

      September 17, 2019 at 12:48 am

      I am 45yrs old i feel in my heart like fluttering or pvc i feel occassional sometime in one day not sometime 3, 5 or 6 time i feel fluttering on my heart but i am already check up by doc all examine they said good function of heart no need treatment but until now i feel occassional pvc

      please give the explaination thank you..

      Reply
  2. Sal says

    February 20, 2018 at 4:52 am

    I’m a 20 year old female and had a ekg 3 times all came back abnormal. Have a heart murmur sent me for a echo and came back with a finding of a increase flow velocity in the LVOR and trace mitral regurgitation, trace tricuspid regurgitation and trace pulmonic regurgitation. My whole chest feels heavy and aches. Hard to breath and left did of chest I have pains and right. Sometimes have vibration sensation in my chest.

    Reply
  3. mal stephens says

    June 4, 2018 at 1:31 pm

    I am sorry but there is an error. Only ten “stickers” are placed on the patient’s body which produce 12-leads.

    Reply
  4. Paul says

    June 15, 2018 at 8:25 pm

    I have a question which none of my medical care folks have been able to figure out. I had a STEMI heart attack 90 days ago, had a stent placed in my LAD and I am in cardiac rehab. At home I have a really nice exercise bike with a built in heart monitor (that uses a chest strap). Prior to the heart attack, the chest strap and monitor worked perfectly on me. After the heart attack the heart monitor does not work. I had my wife try the bike using the chest strap and it works perfectly on her. For me, it picks up no heart rate. I have been diagnosed with PVCs on my ECGs. Are these PVCs the cause of the heart rate monitor on the bike not working?

    Reply
    • Afib says

      October 7, 2019 at 6:31 pm

      That make you the Tin Man! Congrats!

      Reply
  5. Katie says

    March 6, 2019 at 4:38 pm

    The other night my resting heart rate was 48 and I was just feeling bad and having heart palpitations so I went and bought a Fitbit to track my heart rate and I have been wanting one to help me get in shape anyways. But it is reading my resting heart rate as 54 and I am not in shape at all. Last night I was feeling short of breath and I occasionally feel dizzy but I also have an anxiety disorder so idk if its all in my head or if I have heart problems. I have a doctors appointment today but I was just curious what your opinion is. Thank you!

    Reply
    • shannon says

      July 11, 2019 at 10:04 am

      Hello,

      I have the exact same problem, my resting heart rate the other night was 40 and i was really sort of breath and felt i couldnt breath and then sometimes it will go up to 130 and i faint but i also have anxitey, not something i accept but it could all be the cause of it. I have had a heart ultrasound recently and awaiting my results but still put it down to heart problmes. Make your DR do tests anyway just to be sure or if you contact cry they do test days.

      Reply
  6. Joseph says

    May 14, 2019 at 7:20 pm

    Can anyone provide the average cost for a cardiologist to read an EKG?

    Reply
  7. Cathie says

    July 8, 2019 at 8:49 pm

    I had 2 abnormal EKG’s but normal echocardiogram so I’m being told I’m ok. Which is more likely to be correct?

    Reply
    • Dr. Mustafa Ahmed says

      August 5, 2019 at 3:38 am

      The normal echo is reassuring. It depends why the ekg is abnormal. If the EKG has issues with rhythm and such then its unrelated often to the echo and an independent issue. If the EKG says evidence of heart attack or damage, but then the echo is entirely normal, then the normal echo is correct most likely.

      You can follow our twitter at @MustafaAhmedMD

      Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

      Reply
  8. Carrie says

    July 10, 2019 at 8:46 pm

    You’re referring to a cardiac ultra sound. An EKG and an ECG are the same thing. EKG is an outdated way saying it older people often use, from the German acronym, and ECG is from the US acronym.

    Reply
    • Carrie says

      July 10, 2019 at 8:49 pm

      Wait, that’s embarrassing ??. I thought it was electrocardiogram the page was talking about. My bad, disregard!

      Reply
  9. Carol says

    July 30, 2019 at 7:42 pm

    When I have an EKG done is shows as abnormal with a ? of possible MI in the past. To the best of my knowledge I have never had an MI. When I have an Echo done, they always say that it is normal. Why does this keep happening and will the abnormality ever disappear so that I can have a normal EKG?

    Reply
    • Dr. Mustafa Ahmed says

      August 5, 2019 at 4:34 am

      The EKG is not necessarily specific for the damage, the normal echo is likely reasuring.

      You can follow our twitter at @MustafaAhmedMD

      Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

      Reply
  10. Fred Thomas says

    September 12, 2019 at 4:26 am

    I am 72 years old and just had a ECG. My heart rate was 65 but it read that I had a 83 ms sinus arrhythmia. Should I be concerned? I have had a heart murmur that comes and goes. As I got older the murmur went away but this the first time I have been told I had a sinus arrhythmia.

    Reply
    • Dr. Mustafa Ahmed says

      September 22, 2019 at 4:59 am

      Sinus arrhythmia in asymptomatic people in general is not a clinically concerning issue.

      You can follow our twitter at @MustafaAhmedMD

      Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

      Reply
  11. Justin Brasfield says

    September 21, 2019 at 4:29 pm

    I had an echo and was told that all there is trivial insufficiency in the aortic, mitral, pulmonary, and tricuspid valves. I wake every night after 4-5 hours of sleep and feel my heartbeat which is elevated and with higher pulse pressure (60-70). This has been happening for over a month. Also, I am experiencing fatigue and elevated heart rate after showering, heat, and mostly in the morning. I feel better at night.

    I would like to get a second opinion as to my cardiac function and valve leakage.

    Is it reasonable to think my problems may be valve related?

    Reply
  12. Justin Brasfield says

    September 21, 2019 at 4:39 pm

    I had strep a nearly two months ago. A week later I started waking every night after 4-5 hours of sleep. I feel my heartbeat, which is elevated, and with higher pulse pressure (60-70). Also, I am experiencing fatigue and elevated heart rate after showering, heat, and mostly in the morning. I feel better at night.

    I had an echo and was told that all there is trivial insufficiency in the aortic, mitral, pulmonary, and tricuspid valves.

    I would like to get a second opinion as to my cardiac function and valve leakage.

    Is it reasonable to think my problems may be valve related?

    Reply
    • Dr. Mustafa Ahmed says

      September 22, 2019 at 4:02 am

      If indeed trivial and no other structural abnormality noted the valves are not likely to be related to any significant issues.

      You can follow our twitter at @MustafaAhmedMD

      Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

      Reply
  13. Barry says

    October 9, 2019 at 7:28 pm

    Why does the American Heart Association state that an electrocardiogram and EKG are the same, and subsequent sources state the same?

    According to the American Heart Institute, an EKG is an electrocardiogram.

    https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/electrocardiogram-ecg-or-ekg

    http://neurosky.com/2015/05/ecg-vs-ekg-whats-the-difference/

    I am trying to understand more now that my father is going through so many tests.

    Thank you in advance for your time and consideration.

    Barry

    Reply
  14. Hannah brown says

    November 11, 2019 at 10:37 pm

    I’m 28 and have 4 ecgs done the other day result was inverted t waves. What does this mean? All 4 came back the same. I’m getting a scan done to check but no one really told me anything about the results. I’ve been feeling bad for about 10 days pain in chest breathless and pretty dizzy. I assumed I had a chest infection but my chest is clear. All bloods come back okay chest X-ray was fine.

    Reply
  15. J. Koelsch says

    March 1, 2020 at 8:02 pm

    JK writes:
    If results are normal from an EKG, is it necessary to have an Echocardiogram?

    Reply
    • Dr. Mustafa Ahmed says

      April 12, 2020 at 10:00 pm

      It depends on the reason the test is done and the information required.

      You can follow our twitter at @MustafaAhmedMD

      Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

      Reply
  16. Chad Feldman says

    April 9, 2020 at 3:42 am

    I had an echo done recently and my cardiologist said my EF% was at 40%, I’m a 50-yr old fitness trainer in excellent physical shape. When I questioned the Dr he said would Rx me a diuretic & ACE inhibitors, which I wasn’t interested in at all. He then said we could do a heart catheter after 6-months on meds. I demanded the heart catheter ASAP. 5-days later I had the heart catheter done and it showed an EF% of 60% and ALL looked fine…
    Can an ECHO be that far off? The heart catheter is always much more accurate right?
    Thanks in advance for any assistance 🙂

    Reply
    • Dr. Mustafa Ahmed says

      April 12, 2020 at 9:20 pm

      Thats odd. The echo should be the better test, and if ambiguous the MRI, it is not standard to assess function through a cath. I would recommend re-reading or repeating the echo to answer this question as im not sure why they should be different.

      You can follow our twitter at @MustafaAhmedMD

      Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

      Reply
      • Lynne says

        February 5, 2022 at 7:39 pm

        How accurate are readings from a 12-lead ecg? Can results show a false positive reading of an enlarged atrial if the test is being done while you’re having a hypertensive crisis?

        Reply
        • Dr. Mustafa Ahmed says

          February 6, 2022 at 11:29 pm

          They are to be taken in context, i.e the next step would be an echocardiogram to confirm or rule out.

          You can follow our twitter at @MustafaAhmedMD

          Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.

          Reply
  17. Kristine says

    March 30, 2021 at 1:08 am

    My ecg shows suspected MI but my echo was normal. I’m still worrying about my ecg.

    Reply
  18. Linda says

    December 22, 2021 at 10:54 am

    I had ekgs done for the past five years and they came back normal. However December 12, 2021 I had an ekg done and it said I have a prolonged QTc-Bazett which equaled 475. I am a 50 year old female. I drank 2 cups of coffee before the test and I was very nervous. Could this have an impact?

    Reply

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