ECHO On vs ECGRef
Price, ratings, monetisation and update history for both apps, side by side — with what reviewers say about each.
ECHO On
This medical education app helps users learn Transesophageal Echocardiography with a question bank, cognitive aid, case log, and reference library. It provides guidance on performing and interpreting a standard 28-view exam, including anatomy, function, and Doppler interrogations.
- Transesophageal Echocardiography education
- Enlarging question bank
- Rescue TEE cognitive aid
- Case Log system
- Perioperative Quick Reference library
- Offline echo loops
- Pathology, technique, and normal loop examples
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ECHO On is a free medical education resource for learning Transesophageal Echocardiography including a free, enlarging question bank, a Rescue TEE cognitive aid, a Case Log system for submission to the NBE, and a growing perioperative Quick Reference library with offline echo loops that work even in the OR without internet access, and includes pathology examples, techniques, and normal loops of the heart. ECHO On will walk you through an entire standard 28 view exam teaching you the anatomy, function and Doppler interrogations you should perform at each view, and how to interpret them. ECHO On is and will remain free, and the best way you can contribute is to submit boards-style questions or echo stills and echo loops to help grow the QBank, Quick Reference and Pathology libraries. Disclaimer: This app was written to provide an accessible perioperative tool for residents and fellows learning TEE in the cardiac OR and ICU, and for generalist anesthesiologists looking to refresh their knowledge of TEE. It is not meant for patients to self-diagnose. It is not meant to be a definitive reference. Despite my best efforts, there may be errors or inaccuracies in this app, so please do not use it for medical decision making, as doing so may lead you misdiagnose or seriously harm your patient. If you are not a qualified medical doctor, please see a qualified medical doctor before making any medical decisions, including those based on echocardiograms.
ECGRef
An educational reference for interpreting electrocardiograms, this app covers electrophysiology, rhythm recognition, and common patterns. It aims to assist clinicians and students in accurate bedside ECG analysis.
- Electrophysiology concepts
- Rhythm recognition
- Clinically relevant patterns
- Bedside ECG analysis support
- Educational reference
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ECG interpretation, organized for the bedside. ECGRef is a comprehensive electrocardiogram reference for physicians, nurses, advanced practice clinicians, medical students, and other healthcare learners. Use a structured interpretation workflow, review rhythm patterns, explore ECG leads, check diagnostic criteria, and perform commonly used ECG calculations all in one focused reference. FEATURES • Step-by-step ECG interpretation workflow • Rhythm recognition and clinically relevant pattern review • Interactive frontal-plane and precordial lead explorer • Searchable library of ECG terminology and concepts • ECG calculators for heart rate, QTc, cardiac axis, ventricular hypertrophy, bundle branch block, wide-complex tachycardia, and more • Clinical risk tools • Bedside takeaways, common pitfalls, and “do not miss” findings • Favorites, global search, related content, and personal notes ECGRef connects core electrophysiology with practical ECG analysis. Whether you are learning a systematic approach, reviewing an unfamiliar rhythm, or checking a calculation, the app makes relevant information easy to find. Created by Rishi Kumar, MD, FACC (“RK.MD”), an academic adult cardiothoracic anesthesiologist and cardiovascular ICU intensivist committed to free, open-access medical education. Learn more at https://rk.md ECGRef is intended for educational and informational purposes only. It does not provide medical advice and is not a substitute for professional judgment, diagnosis, or treatment. Clinical findings and calculations must be independently verified and interpreted in the context of the individual patient. Seek guidance from a qualified healthcare professional regarding any medical condition. Do not disregard or delay professional medical advice because of information provided by this app.
Screenshots
Verdict
The clearest difference is update cadence: ECHO On at weekly against ECGRef's every 3 weeks. ECHO On also leads on iOS requirement (15.6 vs 26.0). On price, rating, review sentiment and ratings volume there is nothing between them.
Scored on Price · Rating · Positive reviews · Number of ratings · Update frequency · Ads · In-app purchases · Monetization · Best chart rank · Devices · Requires iOS
Both are free to download. Neither carries in-app purchases, so what you see is what you pay.
On the App Store both sit at effectively the same score — 4.9 for ECHO On against 4.9 for ECGRef. Both are backed by a comparable volume of ratings — 15 and 32 respectively. Written reviews split almost evenly too, at 100% and 100% positive.
ECHO On ships an update weekly, ECGRef every 3 weeks. The most recent releases landed on November 3, 2026 and November 5, 2026 respectively.
| Parameter | ECHO On | ECGRef |
|---|---|---|
| Price | Free | Free |
| Rating | 4.9 (15 ratings) | 4.9 (32 ratings) — better |
| Positive reviews | 100.0% of reviews | 100.0% of reviews |
| Number of ratings | 15 | 32 — better |
| Update frequency | Weekly — better | Every 3 weeks |
| Ads | No | No |
| In-app purchases | No | No |
| Monetization | Free | Free |
| Devices | iPhone, iPad, iPod — better | iPhone, iPad |
| Requires iOS | 15.6 — better | 26.0 |
| Further details — not scored | ||
| Size | 414 MB | 13 MB |
| Age rating | 12+ | 17+ |
| Developer | Robert Arrigo | Rishi Kumar |
Customer experience
ECHO On
ECGRef
In-app purchases
ECHO On
No in-app purchases
ECGRef
No in-app purchases









