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EKG vs. Echo - Heart Health can Depend on Both

You’ve had a stress electrocardiogram (EKG) and now your doctor wants you to get a stress echocardiogram (echo). You’re wondering about the difference between the two tests and why you need both.

“When you have an EKG, your heart’s electrical efficiency is measured – we look to see if the pattern is normal, too fast, too slow or erratic,” says Julio Perez, MD, director of echocardiography for Barnes-Jewish Hospital.

“We can also learn if there is abnormality in the shape or size of the heart. An EKG is a good first test, and can show when there is an irregularity that would be associated with heart disease.”

However, an EKG is not very accurate in evaluating the pumping ability of the heart. For that, an echocardiogram is recommended.

According to Dr. Perez, “An echocardiogram (echo) is an ultrasound of the heart. It shows the internal structure, and how the blood flows through it. The echo measures the size and shape of the heart, how well the valves are functioning, how the left and right side communicate, and the velocity of the blood leaving the heart.”

The echo is used to diagnose coronary artery disease, heart valve disorders, enlargement or thickening of the heart muscle.

Dr. Perez adds, “The stress echo combines the information from an EKG and the echo into one test. It can raise the accuracy of the diagnostic test into the 80th percentile. Echos are especially helpful in diagnosing heart problems in women.”

EKGs and echos are ordered by physicians or cardiologists who will interpret the results. Both tests are non-invasive – electrodes are placed on the chest while you exercise. Your physician is contacted immediately if the test is positive, so you can be evaluated further.

If your physician recommends an echocardiogram, please have their office call 314-454-7911 for an appointment.

Echos are performed at  the following locations of the Washington University and Barnes-Jewish Heart & Vascular Centers:

Center for Advanced Medicine
Heart & Vascular Center
4921 Parkview Place, 8th Floor, Suite A
St. Louis, MO 63110

Barnes-Jewish Hospital (South)
Cardiac Diagnostic Lab
One Barnes-Jewish Hospital Plaza, Street Level
St. Louis, MO 63110

Barnes-Jewish West County Hospital
Medical Office Building 1
1020 N. Mason Road, Suite 100
Creve Coeur, MO 63141

South County
11124 South Towne Square
St. Louis, MO 63123

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Copyright 2014 Washington University School of Medicine
Copyright 2014 Washington University School of Medicine