Echocardiogram vs ECG: Heart Ultrasound and the Different Types of Echo

An echocardiogram, or echo, uses ultrasound to produce moving images of the heart. An electrocardiogram, or ECG, records electrical activity. Their names sound similar, but they answer different questions and one should not be substituted for the other when booking a test.

Echocardiogram vs ECG

NHLBI describes echo as a way to assess the heart’s size and shape and how it pumps. It can help investigate valve problems and other structural findings. A clinician may request both tests because electrical and structural information complement each other.

Transthoracic, transoesophageal and stress echocardiograms

Transthoracic echocardiography, abbreviated TTE, is the common examination with a probe moved over the chest. Gel helps the probe make contact, and you may be asked to lie in different positions.

Transoesophageal echocardiography, called TOE or TEE, places a small ultrasound device on a flexible tube in the food pipe to obtain more detailed views. It has different preparation and recovery requirements from an ordinary chest scan. Stress echo assesses the heart when it is working harder, using exercise or medicine under supervision.

How should I prepare?

Confirm the exact type of echo before following preparation advice. You may be able to eat and drink normally for a standard TTE, while a TOE can require fasting. If sedation is planned, ask about transport home and restrictions afterwards. Follow the hospital’s instructions rather than stopping medicines yourself.

Bring the referral, a medicine list and relevant previous reports. Ask whether contrast is planned and tell the team about relevant medical conditions or previous reactions. If you want a chaperone, mention this when arranging the examination.

Understanding the results

Ask the clinician which question the echo answered, whether any views were limited and whether another test or follow-up is needed. Avoid treating one measurement copied from the report as a complete assessment of heart health. Record how and when the results will be discussed, especially when the scan is performed at a different facility from your referring doctor.

Buying a cardiac ultrasound system

A general ultrasound machine should not be assumed to support every cardiac examination. The intended operator should verify the cardiac probe, imaging modes, measurement package and reporting workflow on the exact configuration. Use our ultrasound buying checklist when comparing quotations.

Sources

NHLBI: heart tests; NHLBI: heart-valve diagnosis; NHS: echocardiogram; NHS inform: echocardiogram and ECG. Reviewed 13 November 2026. General education; individual findings need clinical interpretation.