ECG not available on watch but it is

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The watchOS of an Apple Watch is also tied to the country of purchase, and the Apple Watch will always install this specific watchOS, no matter where you activate your watch and which country settings you use.

So in the end you can only use those features, that are part of the watchOS issued for the country of purchase.

watchOS - Feature Availability - Apple

So I have an Ultra 2 bought in US, I activated it while there in the US but with region Argentina and Spanish as language, ECG works fine. I got a series 9 here in Argentina, (watch is from US…) and activated it here and no ECG, I see the same issue as you. Not sure if this is because of the different watches or activating them at different countries. I checked in the site and Argentina is not listed as ready for ECG, but I have mine working just fine so am am a fit lost and frustrated…

It makes sense and it doesn’t… both are watches fro US, both were set to be Argentina, Spanish, te difference is that one was activated while being at US and the other here in Argentina… kinda stupid to me, I mean I may need to put a VPN and act as I’m in US the re activate de Watch… anyways…

Yes, in some countries and regions the ECG is not permitted. Because of country of purchase and activation of Apple Watch, your experience with different Watches and different countries is the issue.