ECG vs ECHO: Key Differences Electrocardiogram and Echocardiography

ECG (Electrocardiogram) and Echocardiogram(Echo) are two common diagnostic tools that help us have information about the health of our heart. Both tests are essential for their insights. They are used for different purposes and give distinct information about the heart. An ECG records the heart's electrical activity, helping to detect

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• Irregular heart rhythms.

• Heart attacks.

• Other electrical abnormalities.

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On the other hand, an Echocardiogram uses ultrasound waves to create images of the heart’s structure and function. Doctors can assess heart chambers, valves, and blood flow using it. The echocardiogram and ECG complement each other. A patient with palpitations is advised to echo to evaluate underlying structural or functional disorders that may be causing abnormal rhythm. The echo, on the other hand, gives us information about the extent of damage in cases of chest pain. 

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We must understand the significance of each test and when to have the one that is required. Gauze guides us in this journey of caring about our heart health and advises us on which test is best for us. In this blog post, we will read about how ECG and Echo work, their uses, and which is needed when.

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Working Principle

In an ECG, when the heart beats, it generates electrical impulses. These impulse travels through the heart, causing it to contract and expand, which helps it to pump blood throughout the body. 

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ECG records the electrical activity helping us gauge if the heart is working normally. The electrical activity in the heart is recorded by electrodes placed over the heart. The signals are amplified by the machine and recorded as a waveform on a tracing sheet. Inconsistent, irregular, and non-standard waves are a sign of heart disease. 

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An echocardiogram is a live imaging test that monitors heart activity using sound waves, hence the name. The high-frequency sound waves create images of the heart’s structure and function. The test helps evaluate the heart’s pumping efficiency and valve function and detect any abnormalities in the heart’s chambers. It records a beating heart to provide functional data.

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Performing a Test

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ECG

Electrodes are placed on the skin of arms, legs, and chest to track and record the electrical activity within the heart. It takes 5 to 10 minutes to perform an ECG of the heart’s rhythm.

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Procedure for the ECG test

It involves the following steps.

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• Preparation: Wear comfortable clothing. Do not apply oil or lotions to the skin. Trim the hair on the chest. Remove all jewelry and metal objects.

• Electrode placement: Electrodes are attached to the chest, arms and legs to capture the signals.

• Recording: Remain still as the machine records.

• Completion: The electrodes are removed And you can resume your activities.

• Post care: Not required unless your healthcare provider advises you.

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Echo

The ultrasound probe is run over after applying an ultrasound conductive gel on the chest. The process takes around 20 minutes to complete. It is advisable to eat light meals and avoid caffeine or nicotine, which can affect heart rhythm before the test.

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When do we Need Them?

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ECG is advised

• When heart surgery is needed.

• On experiencing symptoms of heart attack or stroke.

• When a medical condition that has a risk of heart disease, like hypertension, diabetes, or high cholesterol, is present.

• When other risk factors, including a family history of heart disease, smoking, diabetes, alcohol abuse, or obesity coexist.

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ECG heart tracing provides information on the rhythm and rate of the heart. Heart rhythm disorders such as tachycardia, bradycardia, heart blocks, and irregular beats (atrial fibrillation). It also indicates enlargement of heart muscle abnormalities and is the test of choice in patients with chest pain. Echocardiograms are advised to confirm signs and symptoms of heart disease.

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They help to detect

• Structural defects in heart chambers and valves.

• Diagnose the cause of chest pain and shortness of breath.

• Abnormalities in unborn fetuses.

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An echocardiogram records moving pictures of the heart. It provides information on leaky valves and heart pumping function, so it is a test of choice for evaluating heart failure.

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Electrocardiogram

Electrocardiograms are essential tools in diagnosing and monitoring heart health. It ensures:

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• Accurate diagnosis.

• Effective treatment plan.

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Why do we need ECG testing?

An electrocardiogram is an essential tool for diagnosing and monitoring heart health. It helps us in:

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• Diagnosis.

• Effective treatment plan.

Why do we need ECG testing?

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The ECG gives information about heart rhythm and function and is essential for diagnosing various cardiac conditions. The increasing occurrence of heart disease and risk factors such as hypertension and diabetes explain the importance of ECG testing.

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Regular ECG enables healthcare professionals to:

• Monitor heart health effectively

• Identify potential issues

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Monitoring heart health

An ECG monitors heart health and records the electrical activity of the heart. It records irregular heartbeats that indicate underlying issues. Understanding the heart's rhythm and function performance is essential in ECG as it indicates if further investigation and treatment are necessary.

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Diagnosing cardiac conditions

ECG tests diagnose various cardiac conditions, including arrhythmias, heart disease, and potential heart attacks. It captures abnormalities in the heart’s electrical signals, allowing doctors to detect issues early.

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Timely diagnosis helps to

• Improve treatment outcomes.

• Reduces the risk of severe complications.

• Ensures medical intervention when needed.

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 Importance for high-risk individuals

 Regular ECG testing is necessary for individuals with risk factors such as:

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• Family history of heart disease.

• Hypertension.

• Diabetes.

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ECGs provide information about heart health and can lead to early detection of diseases. By monitoring heart activity through ECG, healthcare providers and patients adopt preventive measures and establish effective treatment plans to maintain cardiovascular health.

Types of ECG

Different types of ECGs are useful in specific clinical conditions, making them indispensable in modern medicine. Each ECG type has distinct applications. Patients and healthcare professionals can make informed decisions based on the understanding of the differences.

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Resting ECG

A patient lies down comfortably while a resting ECG is performed and the electrical activity is recorded. It helps identify arrhythmia, heart enlargement, and prior heart attacks. The baseline information about heart function is provided by resting ECG. They enable healthcare providers to assess overall cardiac health and determine the need for further testing or treatment.

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Exercise ECG / Stress test / Treadmill test.

It is done as a patient walks or pedals a stationary bicycle to monitor:

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• Heart

• Breathing

• Blood pressure

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During stress or exercise the stress test helps to detect coronary artery disease and to determine safe exercise levels following a heart attack or surgery.

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Holter Monitor

It is a portable ECG device worn for 24 to 48 hours. It continuously records heart activity and captures intermittent rhythms, providing a comprehensive assessment of heart rhythm.

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Event Monitor

An event monitor is akin to a Holter monitor. It is worn for up to 30 days. Patients switch ON the device on experiencing symptoms such as palpitations or dizziness, capturing heart data during these events.

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It is beneficial for diagnosing transient arrhythmias that may be missed during standard tests. Advancements in technology have enabled smartphones and other fitness trackers to record ECG data. They help to monitor heart health regularly.

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Echocardiogram

High-frequency sound waves are used to create real-time images of the heart in an echocardiogram. 

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• Ultrasounds help to visualize hard structures.

• Gives detailed information on heart size, shape and valve function.

• It assesses heart pumping efficiency and detects abnormalities and other heart conditions.

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ECHO is a comprehensive evaluation of heart structure and function compared to ECG.

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Types of Echocardiography

Different types of echocardiograms are used to determine information the healthcare professional needs.

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Transthoracic echocardiogram or TTE

• It is the standard non-invasive ultrasound.

• It is performed by placing a transducer on the chest. 

• The gel used on the skin helps to facilitate sound wave transmission. 

• It creates a picture of the heart from outside the body. 

• Contrast dyes are injected intravenously to help the structures show better.

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Transesophageal echocardiogram TEE

 A flexible, thin transducer is inserted down the throat to obtain clear images of the heart.

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• It is useful for assessing conditions like heart valve problems, atrial septal defects or blood clots.

• The procedure requires sedation of the patient.

• More preparations are required than for a thoracic echocardiogram.

• It provides a detailed look at the heart and the body's main artery, the aorta.

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It should not be performed. If you have

• Bleeding in the upper GIT

•  A tumour

• Tear in the esophagus.

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Fetal echocardiogram

• It is performed during pregnancy to check the baby's heart.

• It is a non-invasive test that allows the healthcare professional to see the baby's heart without surgery or X-rays.

• It is recommended during high-risk pregnancies and for identifying congenital heart defects or other heart-related issues before birth.

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Stress echocardiogram

• It is done right before and after exercise at a medical office. It is used to check how the heart responds to physical activity or stress.

• The test helps to identify coronary artery disease and other cardiac conditions that may not be apparent at rest.

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Echocardiogram methods 

Parts of an echocardiogram are:

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Two-dimensional or Three-dimensional echocardiograms

• These images provide pictures of heart walls, valves, and blood vessels.

• A standard echocardiogram is a 2D study of the heart.

• A 3D echocardiogram is a specialized method available at select centers. It is done for detailed information on the lower left heart chamber.

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Doppler echocardiogram

• When sound waves bounce off, blood cells move through the heart and blood vessels, its pitch changes. These changes are called Doppler signals.

• It measures the speed and direction of blood flow within the heart and vessels.

• It shows blocked or leaking valves and checks blood pressure in heart arteries.

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Color flow imaging

• Shows blood flow in color.

• Helps find leaking valves and changes in blood flow.

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Side Effects of ECG and Echo

• They carry a negligible risk of adverse effects.

• During a transoesophageal echocardiogram, a person may gag or experience soreness in the throat.

• An allergic reaction to local anesthesia, sedatives, and contrast dyes may occur.

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Difference Between ECG and Echo

ECG and Echo are diagnostic tools in cardiology. They have distinct purposes and provide different information about the heart.

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Method

• ECG measures the electrical activity of the heart by electrodes placed on the skin. 

• Echo uses sound waves to create detailed images of heart structure and function. 

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Purpose

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ECG detects 

• Rhythm abnormalities.

• Conduction disorders.

• Myocardial ischemia.

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Echo evaluates

• Heart structure.

• Function.

• Valve condition.

• Blood flow.

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Duration

• ECG takes 5 to 10 minutes.

• Echo takes 20 - 60 minutes.

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Results

• ECG immediate results show electrical activity.

• Echo results are available after an analysis by an expert.

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If heart diseases are to be managed effectively, it is essential to identify ECG patterns and waveforms.

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Use

• ECG is used for routine check-ups and diagnosing arrhythmias.
• Echo is used for diagnosing structural heart problems and blood flow functions.

Cost

• ECG is less expensive.

• Echo is more expensive.

Conclusion

Both Echocardiography and ECG are tools in cardiology. ECG evaluates the heart's electrical impulses, and Echocardiography gives a detailed view of heart structure, function, and blood flow. Together, they provide information to help healthcare providers diagnose and manage heart-related issues.

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Gauze combines cutting-edge, state-of-the-art technology with a team of professionals who ensure diagnosis and comprehensive care. From online appointments to scheduled detailed consultations, Gauze has it covered.