In short
An ECG records the heart’s electrical activity. An echocardiogram uses ultrasound to show the heart’s structure and how well it pumps. An exercise stress test shows how the heart responds to physical effort. Each answers a different question, so a cardiologist may recommend one, several or none.
ECG (electrocardiogram)
Small sticky pads (electrodes) on the chest, arms and legs record the heart’s electrical signals for a short time. In general, an ECG can show rhythm problems and some signs of strain or a previous heart attack. Because it is a brief snapshot, a rhythm problem that comes and goes may not appear. This is general information about the test; please confirm with the practice which investigations it arranges.
Echocardiogram
A handheld ultrasound probe on the chest produces moving pictures of the heart. It shows the size and pumping strength of the chambers, the thickness of the muscle, and how the valves open and close. It is painless and does not use radiation. Transthoracic echocardiography is offered at the practice.
Exercise stress test
You walk on a treadmill at gradually increasing effort while your heart rhythm, blood pressure and symptoms are monitored. It helps show whether symptoms such as chest discomfort may be linked to reduced blood flow during exertion, and how well you tolerate exercise. Exercise stress testing is offered at the practice.
An easy way to remember
Think of the heart as a house:
- ECG — checks the electrical wiring
- Echocardiogram — looks at the rooms, walls and doors (chambers, muscle and valves)
- Stress test — checks how the house copes when everything is switched on at once
No single test gives the whole picture
Results are interpreted together with your symptoms and examination. A normal result does not always rule out a problem, and an unusual result does not always mean disease. Your cardiologist will explain what your results mean for you.
Questions to ask your clinical team
- What question is this test meant to answer?
- Is there anything I need to do to prepare?
- How will the results change my care?
Common questions
Do I need to prepare for these tests?+
Preparation differs by test. The practice will tell you about any preparation when your test is booked.
Do any of these tests hurt?+
In general, no. The ECG pads and the ultrasound probe are painless; a stress test involves exercise effort, and is stopped if you become unwell.
Sources and further reading
General patient education written in plain language and informed by the sources above. It is not a substitute for an individual assessment, and does not describe practice-specific fees, referral rules or preparation — please confirm these with the practice.