EKG or Echocardiogram? What Each One Tests
These two get confused constantly, including by people who have had both. The short version: an EKG listens to the heart's electrics, an echocardiogram looks at its plumbing. They are not alternatives to one another and ordering one does not substitute for the other.
What an EKG tests
An electrocardiogram records the electrical activity that makes the heart beat. Stickers go on the chest, arms and legs, wires clip to them, and the machine records for a few seconds. It is painless, involves no radiation, and the whole thing is usually over in under ten minutes.
It answers questions about rate, rhythm and conduction: is the heart beating too fast or too slow, is it beating regularly, is the electrical signal travelling normally, and is there evidence of strain or a previous event. It is the right first test for palpitations, an irregular pulse, or pre-operative clearance.
What it cannot tell you is how well the heart is pumping or whether a valve is leaking. For that you need pictures.
What an echocardiogram tests
An echocardiogram is an ultrasound of the heart. Same technology as any other ultrasound, pointed at a moving organ. A transthoracic echo shows the chambers, the walls, the valves and the direction and speed of blood moving through them, using colour Doppler to make flow visible.
It answers structural questions: how well is the heart pumping, are the valves working, are the chambers enlarged, is there fluid around the heart. It is the study for shortness of breath, suspected heart failure, a murmur, or following up a known valve problem.
It takes 30 to 60 minutes and needs no preparation. Reads typically come back within 24 hours.
Why you might get both
Plenty of cardiac workups involve both, and that is not duplication. An irregular rhythm found on an EKG raises the question of whether the heart's structure explains it, which is an echo question. Shortness of breath that turns out to be a valve problem on echo still needs an EKG to check the rhythm. They are complementary, not competing.
What each costs
A transthoracic echocardiogram is $650.53 cash, and that includes the radiologist's read. It is CPT 93306 on our published price list.
EKG is not on the published list. Call (855) 249-9729 and we will quote it rather than print a number that might not apply to your situation.
Where we do them
EKG is available across our Montana hubs and in Cheyenne, Wyoming. Echocardiograms are available in Montana; Cheyenne currently carries X-ray and EKG only. Coverage is not identical in every market and we would rather say so here than have you drive somewhere for a study we do not perform there. The locations page lists what each hub offers.
Both travel. A technologist can perform either at a home, clinic or care facility, which for a frail patient is often the difference between getting the test and skipping it.