A heart test, like an echocardiogram or electrocardiogram (ECG or EKG), can help evaluate how well the heart is working and detect possible signs of heart disease. These tests are often part of routine care for people with heart-related symptoms, risk factors or known cardiovascular conditions. Knowing what these tests show and what to expect may help you feel more prepared when it’s time to talk with your doctor.
What Is an Echocardiogram?
An echocardiogram, also called an “echo,” is a test that uses sound waves to create live images of the heart. It helps doctors see the heart’s size, shape and movement. The test may show how well the heart is pumping blood, and it can also check the heart valves and look for signs of fluid buildup or damage.
Doctors may recommend a heart echocardiogram for people with symptoms like shortness of breath, chest discomfort or irregular heartbeats. It may also be used for patients with known heart conditions to monitor changes over time. For those with risk factors like high blood pressure or a history of heart disease, the test can help check how the heart is functioning.
What Is an Electrocardiogram Test?
An electrocardiogram test, or ECG (also known as EKG), is a test that records the electrical activity of the heart. Every time the heart beats, it produces small electrical signals. The ECG captures these signals through electrodes placed on the skin and shows them as waves on a graph.
This test helps doctors check the heart’s rhythm and rate. It may also show signs of a previous heart attack, irregular heartbeat or other electrical problems in the heart. While it doesn’t show the structure of the heart, it gives important information about how the heart is working at that moment.
Doctors may recommend an ECG for people who have symptoms like chest pain, palpitations, dizziness or shortness of breath. It may also be used to check heart health in patients with conditions such as high blood pressure, heart disease or after surgery.
Can an EKG Determine a Heart Attack?
An EKG may help detect signs that may point to a heart attack. When someone has a heart attack, part of the heart muscle may not get enough blood flow. This can change how electrical signals travel through the heart. These changes may appear on the EKG as specific patterns—such as ST segment elevation, abnormal Q waves or changes in the T wave—that trained providers can recognize.
However, an EKG reflects the heart’s electrical activity at the moment the test is done. It may show active changes during a heart attack or signs of a past one. If results are unclear or symptoms don’t match the findings, doctors may recommend more tests for a clearer diagnosis.
What Will an Echocardiogram Show?
An echocardiogram uses sound waves to create moving pictures of the heart. It shows how the heart beats and how well it pumps blood. This test helps doctors see the heart’s structure in real time—like the size and shape of the heart chambers, the movement of the heart walls and how the valves open and close.
An echocardiogram procedure may also show if fluid is building up around the heart or if there are areas of the heart muscle that are not moving normally. It may help detect conditions like valve problems, weakened heart muscle or signs of heart failure. This test is often used when someone has symptoms like shortness of breath, chest discomfort or swelling in the legs. It may also help check the heart health in people with high blood pressure or other heart conditions.
How Is an Echocardiogram Done?
Before the Test
Most of the time, no special preparation is needed. Patients can usually eat and take their medications as usual. Depending on the type of echocardiogram being done, your doctor may give you specific instructions. For example, if you're scheduled for a stress echocardiogram, you may be asked not to eat or drink for a few hours beforehand.
During the Test
You’ll lie down on an exam table. A small device called a transducer is placed on your chest after a gel is applied. The gel helps the sound waves travel from the transducer into your body. The transducer sends out sound waves that bounce off your heart and create images on a screen.
The test is painless, but you may feel a little pressure from the device as it's moved around. You may also be asked to change positions or hold your breath for a few seconds to help get clearer images.
There are different types of echocardiograms. Most are done from outside the chest (transthoracic), but in some cases, a thin tube with a transducer at the end may be passed down the throat (transesophageal) for a closer view. Your doctor will let you know which kind is right for you.
After the Test
You can usually go back to your normal activities right away. If your test involved mild sedation, such as with a transesophageal echocardiogram, you may need a short recovery period and someone to drive you home. The images collected during the test are reviewed by your doctor to look at your heart’s structure and function. Your doctor will discuss the results with you and what they may mean for your health.
