# iElastance vs EchoRef

The clearest difference is update cadence: EchoRef at every 2 months against iElastance's every 8 months. iElastance's advantage is iOS requirement (15.1 vs 26.0). On price, ads, in-app purchases and device support there is nothing between them.

Both are free to download. Neither carries in-app purchases, so what you see is what you pay.

iElastance ships an update every 8 months, EchoRef every 2 months. The most recent releases landed on October 4, 2026 and October 15, 2026 respectively.

## The numbers

| Metric | iElastance | EchoRef |
| --- | --- | --- |
| Price | Free | Free |
| Rating | — | **[4.9 (1.4K ratings)](https://appshunter.io/ios/app/echoref/id1434016053/reviews)** |
| Number of ratings | — | **1.4K** |
| Positive reviews | — | 100.0% of reviews |
| In-app purchases | No | No |
| Ads | No | No |
| Update frequency | Every 8 months | **Every 2 months** |
| Monetization | — | Free |
| Size | 22 MB | 105 MB |
| Requires iOS | **15.1** | 26.0 |
| Devices | **iPhone, iPad, iPod** | iPhone, iPad |
| Age rating | 12+ | 17+ |
| Developer | [Pietro Bertini](https://appshunter.io/developer/1769996267) | [Rishi Kumar](https://appshunter.io/developer/1434016052) |

## What reviewers say

### iElastance

[App page](https://appshunter.io/ios/app/ielastance/id556528864)

**Features:** macOS Compatibility

**In-app purchases:** none


### EchoRef

[App page](https://appshunter.io/ios/app/echoref/id1434016053)

This educational reference app provides comprehensive information on point-of-care ultrasound (POCUS), echocardiography, and cardiac measurements. It includes lessons on interventional procedures and hemodynamic calculations for medical professionals.

**Highlights:** Point-of-care ultrasound (POCUS), Transthoracic echocardiography (TTE), Transesophageal echocardiography (TEE), Cardiac dimensions and valve measurements, Hemodynamic and ultrasound calculations, Interventional procedure lessons

**Features:** macOS Compatibility, Vision Pro support

**In-app purchases:** none


## Frequently asked questions

### Is iElastance free?

iElastance is free to download, with no in-app purchases.

### Is EchoRef free?

EchoRef is free to download, with no in-app purchases.

### Do iElastance or EchoRef have ads?

Neither iElastance nor EchoRef shows ads.

### Which is updated more often, iElastance or EchoRef?

iElastance ships an update every 8 months, and EchoRef every 2 months. Most recently, iElastance was updated on October 4, 2026 and EchoRef on October 15, 2026.

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*Compared by [AppsHunter](https://appshunter.io/) from daily US App Store data. Review summaries are generated from verbatim App Store reviews.*