Heart Health: When to Opt for an Echocardiogram or an ECG

Ask any passerby what’s needed for a heart examination, and you’re likely to hear: “An ECG and a heart ultrasound.” But do we all know the differences between these tests and when an ECG alone might not suffice? We invited the renowned blogger Nina Bogdanova to undergo an examination with her sons, Herman and Stefan, at the “Kordis” clinic. While Nina and the boys were under various sensors and wires, a journalist questioned the doctors about the essence of the examination.

Project: “Heart, You’re Simply Out of This World!”

Ekaterina Dubovik, a Category I doctor of functional and ultrasound diagnostics, explained the basics of ECG and heart ultrasound:

What is an ECG?

An electrocardiogram (ECG) records the heart’s activity, helping us identify heart rhythm abnormalities and their causes. These causes can range from poor nutrition and blood supply to the organ, with the most severe being a myocardial infarction. The process involves attaching sensors to the arms and the heart’s projection area, then recording the activity on a strip. We then examine various leads that correspond to different parts of the heart. An ECG allows us to see all areas of the heart.

What is an Echocardiogram?

An echocardiogram is a more comprehensive method. It helps visualize the heart’s structure using ultrasound. The heart is scanned from different angles to assess its overall function. Our equipment can create a 3D projection of the heart, allowing us to observe blood flow through the valves, check for any abnormalities like extra holes, and assess the heart’s contractility and blood supply. We can also detect any interruptions in the arteries, such as thrombi or plaques.

When and Who Should Undergo a Heart Ultrasound and ECG?

Olga Ageenko, a Category I cardiologist, explains that a comprehensive examination of the cardiovascular system should be regularly undertaken by individuals over 40 and those with a family history of heart disease. This includes people with:

Excess weight
High blood pressure
High cholesterol levels
Diabetes
Relatives with heart disease, or those who have had strokes or heart attacks

A comprehensive examination includes:

An initial consultation with a cardiologist
An electrocardiogram
A heart ultrasound
Blood tests

It’s crucial for the doctor to know your lipid profile (a blood screening test). Some patients may require a stress test or 24-hour blood pressure monitoring. The initial consultation must include a calculation of the risk of cardiovascular complications, which we do using the European SCORE scale. Lastly, I want to say that women are more proactive about their health than men. Therefore, it all starts with the woman! Besides taking care of herself, she also monitors the health of the entire family. Every woman should bring her husband to a cardiologist, as men often come in with advanced diseases.

Non-Obvious Symptoms: From Sleep Apnea to Premature Graying

Cardiovascular diseases can present with non-obvious symptoms, says Olga Ageenko. These symptoms can mimic those of neuralgia or diseases of the gastrointestinal tract, spine, kidneys, or lungs, so a quality examination is necessary for an accurate diagnosis.

Here are some typical and atypical signs of heart disease:

Chest pain, with or without radiation to other parts of the body
Changes in pulse: slow, rapid, or irregular
Difficulty breathing, shortness of breath, cough
Swelling in the lower extremities
Dizziness, both after exertion and at rest
High blood pressure
Sleep apnea
Nausea
Excessive sweating
Libido problems
Blurred vision
Changes in the nail plate
Gray, bluish, or pale color of the lips and fingers
Even premature graying and hair loss

Ekaterina Dubovik adds: “There are indeed many warning signs that should prompt a visit to the doctor. These include an increased heartbeat at rest, worsening headaches during stressful situations, a feeling of pressure or squeezing in the heart, or realizing that usual activities that were once easy are now difficult or accompanied by shortness of breath. If you feel that your heart is beating and then stops for a split second, or if your pulse is irregular, you should also see a doctor.”

How Often Should You Undergo a Preventive Examination?

If No Pathologies Are Detected

You should visit the doctor once a year. This attention to your health allows you to keep the situation under control and take timely measures at the slightest changes.

If Pathologies Are Already Present

A scheduled examination should be done depending on the clinical situation (approximately every six months). If symptoms of cardiovascular disease worsen, you should immediately consult a specialist without waiting for the symptoms to intensify and your well-being to deteriorate.

Stroke and heart attack are particularly dangerous in this regard, as these conditions require urgent medical intervention.

“Mild” Heart Attack: The Dangers of the Aftermath

“Heart attacks are often complicated by pulmonary edema, strokes lead to cognitive impairment, and vascular diseases, especially against the background of diabetes, can cause gangrene and amputation,” warns Olga Ageenko.

Is Surgery Always Necessary?

Not all heart diseases require surgical intervention. But even if it’s unavoidable, in most cases, it’s possible to use endovascular (minimally invasive) methods.

List of Examinations: Ask Your Doctor What You Need

So, we found out that even if you don’t have obvious heart problems, visiting a cardiologist once a year is a must. Children should also be examined at 1 year, 3 years, and 6-7 years old—ECG and ultrasound.

What else should you monitor?

It’s important to control blood pressure levels, heart rate, cholesterol, and glucose values, as serious complications are often found in hypertension and diabetes. Smokers, patients who are overweight, and people with a family history of heart disease should also pay close attention to their health and visit a cardiologist.

Let’s go through the list of examinations again. To detect diseases of the vessels and heart, the following are prescribed:

Cardiography (ECG)
Heart ultrasound (EchoCG)
Stress tests
24-hour monitoring (a portable device worn for several hours or days)
Duplex or triplex scanning (often prescribed for problems with vessels)
Laboratory tests

Nina Bogdanova and her sons have healthy hearts: the ECG and ultrasound showed no abnormalities. Nina is glad:

“I am sure that prevention is better than treating a disease. I have a checklist of certain points, and a heart examination is included. It’s especially important to get checked now, during the autumn period, when additional chores related to school and sports activities begin. This is a load not only for children but also for me. Moreover, the older son left hockey due to some nuances with the heart identified on the ultrasound earlier. Now, thank God, everything has normalized, but I continue to carefully monitor the situation. By regularly visiting doctors, I instill in my children a simple but very important habit—taking care of themselves.”