The EKG is when they put little electrodes (stickers) on your chest, arms and legs and attach you to a host of wires... this shows the electrical activity in your heart at that exact moment. It can show fast or slow rhythms, old heart attacks or other things like that.
And Echo is just an ultrasound
of your heart. Like pregnant women get to view their babies. They put gel on you and roll a tranducer on your chest. I think they can be more helpful at times because you get a real time view of the heart on the monitor and you can get more data whereas an EKG is just info based on a split second..
Neither one hurts by the way.