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The problem with both these tests are that they study the heart at rest and sometimes abnormalities may be picked up only when the heart is stressed and therefore combining these modalities with a stress test can be even more helpful and by far the best form of stress is exercise. You can only diagnose it in retrospect.
Generally the ECG or ECHO does not tell you about the blood vessels until when the blood vessels are so critically narrowed that the heart muscle is actually suffocating. So we need different tests when we are evaluating the heart arteries. The dye goes where blood goes and the heart lights up in dye.
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