The consultation usually comes first
The useful test follows the question. An ECG alone may not explain every symptom, and an echo alone may not catch an intermittent rhythm problem.
Many pathways therefore start with a clinical visit, then add one or more tests.
Echocardiography
Ultrasound shows chambers, valves, and pumping motion in broad terms. It is often used when the question is about muscle function, valves, or chamber size.
An echo does not show every coronary artery narrowing. If the concern is reduced blood supply, the doctor may discuss a different path.
ECG
An ECG records electrical activity in a few minutes. It may show rhythm changes or other signals that the clinician reads with the symptoms. A short resting tracing can still be normal if symptoms happen at other times.
Stress ECG and Holter
A stress ECG watches the heart during measured effort. A Holter watches it for hours in daily life. Both extend the ECG. They do not replace echocardiography for every question.
When to contact the clinic
If symptoms persist or worry you, or another doctor asked for a cardiac opinion. Do not wait for a clinic slot in an emergency.