Echocardiogram vs ECG

If you are experiencing symptoms that suggest a heart problem, you may be advised to undergo tests such as an echocardiogram and an ECG to determine the cause. According to Harvard Medical School, the average heart beats approximately 2.5 billion times in a lifetime, which is a significant amount of work. We must understand what is happening inside the heart, as our heart should maintain this efficiency for wellness and health.

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Getting diagnosed with a heart disease is scary; however, ECGs and echocardiograms are two common tests that analyse heart conditions painlessly. In this blog, we will discuss which test is important for doctors to examine matters of the heart.

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Understanding heart health screening:-

Most individuals are categorized into low, intermediate, or high risk, which dictates the type of screening required. The factors influencing the severity of heart disease risk in a person are

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1. Age: Older people are at greater risk

2. Sex and ethnicity: Some conditions are linked to a high risk of heart disease in certain groups of people

3. Smokers have a high risk of heart disease compared to non-smokers

4. Comorbidities such as hypertension and diabetes

5. Family history of premature coronary artery disease

6. Lifestyle: sedentary habits, overindulgent in unhealthy food 

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Regular heart assessments are advised to prevent cardiac events such as heart attacks and strokes. Individuals at low risk can undergo a heart assessment every 5 years, while those with intermediate or high risk need screening every 2 years. 

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Types of heart check-ups:-

After the age of 30 or 35, it is recommended that you get your heart checked regularly. The effectiveness of the treatment increases if you are detected with any risk.

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The routine screening test required includes:-

• Lipid profile and blood pressure
• Blood glucose test
• BMI (body mass index) measurement based on their waist circumference and body weight

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Other specialised heart tests are

• ECG
• Electrocardiogram
• Exercise cardiac stress test
• Nuclear stress test
• Coronary angiography

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Electrocardiograms (ECGs): What are they and how do they work?

ECG measures the heart's electrical activity.

• As the heart beats, it produces an electrical impulse. This impulse passes through the heart and helps it pump blood.

• The ECG helps the doctor to know if the electrical activity is normal.

• ECG is a waveform representing the heart's electrical rhythm.

• A healthy heart’s ECG shows a uniform structure, while an unhealthy heart shows irregular waveforms.

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Working of ECG

Small electrodes are placed on the arms, chest, and legs. These electrodes detect electrical signals produced by the heart during each beat. These are amplified and recorded on paper as a graph or waveform. The ECG wave is made up of components, such as P, Q, R, S, and T waves, which correlate with electrical events during the cardiac cycle.

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Different types of ECG:

1. Resting 12-lead ECG

It is a standard test typically performed as a routine check-up and is conducted when the patient is relaxed and at ease. It helps to detect abnormalities in the heart.

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2. Exercise ECG or stress test.

It is done to see how the heart reacts to different levels of physical activity.

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3. Cardio pulmonary exercise test (CPET)

It is done to assess the fitness of athletes or those about to begin an exercise program. It checks the heart function at different levels of activity.

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4. Holter monitor

It is a continuous 24-hour ECG monitor worn by the patients. It helps detect heart rhythm disorders, such as atrial fibrillation and ventricular tachycardia.

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5. Signal-averaged electrocardiogram (SAECG)

It is a test that checks the electrical activity of the heart, detecting abnormalities in the heart's electrical circuitry.

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What is an echocardiogram?

An echocardiogram (echo) is a simple, non-invasive test that uses high-frequency sound waves to create real-time pictures of the heart. It helps doctors see the:-

• Size

• Shape

• Movement of the heart

• How will the heart valves work

• How the blood flows through the heart

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Working of an echocardiogram:-

Water-based gel is applied on the chest, and a hand-held device called a transducer is moved over the skin of the chest. This device sends sound waves that bounce off the heart to create images on the screen.

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Its special feature, called Doppler, shows how

• Blood moves through the heart

• It helps to detect leaky valves

• abnormal blood flow

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Different types of echocardiograms

1. Transthoracic echocardiogram

• It is the most commonly done echo to check for heart abnormalities
• It uses ultrasound to study the structure and function of the heart

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2. Transesophageal echocardiogram

• It is a minimally invasive procedure in which the transducer is inserted into the oesophagus to obtain clearer images. It is performed under sedation.

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3. Stress echocardiogram

• It utilizes ultrasound technology to study the heart's structure and function in real-time. The test is commonly performed on athletes to detect any signs of impending heart disease.

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When do we need ECGs and echo?

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ECG is required when we have:-

1. Irregular heartbeat: ECG helps detect abnormal heart rhythms

2. Chest pain may be due to a heart attack or angina

3. A history of a heart attack. It monitors heart function after an attack

4. To assess the efficacy of heart disease treatments

5. Symptoms like dizziness, palpitations, or shortness of breath indicate heart rhythm abnormalities

6. Routine check-up for individuals with risk factors.

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An echocardiogram:-

Provides detailed images of the heart structure and function. It helps to

1. Ensure that the heart valves, chambers, and pumping efficiency are normal.

2. Identify if cardiac conditions are causing the problems or the symptoms. It helps diagnose heart failure, valve disorders, and other structural issues.

3. Detect congenital heart problems before birth. Foetal echocardiography is used for these purposes.

4. Evaluate heart damage from previous heart attacks and assess heart muscle function.

5. Detect fluid accumulation around the heart (Pericardial effusion). 

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Performing the test 

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ECG

A standard 12-lead ECG uses 10 electrodes, four on the limbs and six on the chest. These electrodes detect electrical impulses generated by the heart, which are displayed as waveforms on the monitor. The procedure is quick and takes 5 to 10 minutes to complete. It is completely non-invasive and safe. 

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A cardiac stress test assesses how the heart responds to physical exertion. A stress test ECG can be performed as the individual exercises.

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Echocardiogram

An echocardiogram creates real-time images of the heart in motion. It can assess heart structure, function, and blood flow. 

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The most common type of echo usually done is the transthoracic echocardiogram (TTE). It is performed using a handheld probe or transducer that is continuously moved across the chest with a water-based gel. The transducer produces high-frequency sound waves that bounce off the heart structures, creating images on the screen.

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In some cases, a transesophageal echocardiogram (TEE) is done. A probe is inserted into the esophagus to obtain clearer and more detailed images. Though this technique is minimally invasive, it requires sedation.

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How are Echocardiogram and ECG used?

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Echocardiogram

1. Diagnosing heart conditions: They help identify cardiomyopathy, congenital heart disease, and valvular diseases.

2. Evaluating heart valves: They help to detect how well the heart valves are working, and problems like narrowing or leakage from the valves.

3. Assessing heart functions: To measure the heart's pumping ability, ejection fraction, and overall efficiency.

4. Detecting coronary artery disease.

5. Congenital heart defects.

6. Assessing the damage that has occurred to the heart after a heart attack.

7. Guidance during cardiac surgeries.

8. Detecting the presence of fluid around the heart.

7. A stress echocardiogram helps to assess how the heart works under stress.

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ECG

• Diagnosing: heart conditions like arrhythmias, heart attacks, and some structural abnormalities.

• Monitoring and assessing: treatment effectiveness, readiness for surgery, and emergency conditions.

• Other applications: preoperative evaluation, general health assessment, and as a diagnostic tool for several heart conditions.

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Differences: Echocardiogram vs ECG

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Side effects of echocardiogram vs ECG

Echocardiograms carry a negligible risk of side effects. During a transesophageal echocardiography, a person may experience gagging, and after the test, some patients experience soreness in the throat. Anaesthetics, sedatives, and contrast dyes used induce an allergic reaction in some individuals.

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ECG carries no risk and is a safe procedure. 

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Conclusion

ECG and echo play an important role in cardiac diagnostics. They offer distinct perspectives on heart functioning. ECG tells us about the electrical aspects, whereas the echo tells us about the mechanical performance. Both of these tests are complementary, and they help us create personalised treatment plans and improve heart care. For an echocardiogram and ECG, reach out to us at Gauze. We offer a comprehensive package tailored to your specific needs.