Echocardiogram

An echocardiogram is recommended in a range of clinical situations:

• A heart murmur has been detected — the echo determines the cause (valve disease, structural defect, cardiomyopathy) and its severity
• Signs suggesting heart failure: cough, difficulty breathing, exercise intolerance, fainting (syncope), or abdominal swelling from fluid accumulation
• Monitoring known heart disease — particularly mitral valve disease (the most common heart condition in dogs) and hypertrophic cardiomyopathy in cats
• Evaluating certain breeds at higher baseline risk: Cavalier King Charles Spaniels, Dobermans, Boxers, Maine Coons, Ragdolls
• Pre-anesthetic cardiac assessment in dogs and cats with known or suspected heart disease
• Confirming pericardial effusion (fluid around the heart) or a cardiac mass

Echocardiography provides detailed information that no other single test can offer:

• Valve disease: mitral valve degeneration (MVD/MMVD) — the most common heart disease in dogs; tricuspid valve disease; degree of regurgitation (leaking)
• Cardiomyopathy: dilated cardiomyopathy (DCM, enlarged and weak heart), hypertrophic cardiomyopathy (HCM, thickened walls — the most common heart disease in cats)
• Congenital defects: patent ductus arteriosus (PDA), pulmonic or aortic stenosis, ventricular or atrial septal defects
• Pumping function: ejection fraction and fractional shortening — quantifying how efficiently the heart contracts
• Pericardial effusion: fluid around the heart causing cardiac tamponade
• Cardiac masses: tumors on the heart wall or around the aorta

The echocardiogram is performed using the same ultrasound technology as abdominal imaging, but with cardiac-specific probes and software optimized for the moving heart:

• Your pet lies on a padded table or a special cardiac table with a cut-out that allows the probe to be placed under the chest from below — the preferred position because gravity assists contact
• Fur over the chest is clipped or wet-parted to improve probe contact
• Ultrasound gel is applied and the probe is held against the chest wall
• Dr. D'Urso acquires a series of standard views from both sides of the chest, measuring chamber dimensions, wall thickness, valve motion, and blood-flow velocities using color and spectral Doppler
• Measurements are compared to validated breed-specific and weight-based normal reference ranges

A complete echo study takes approximately 30–60 minutes.

Preparation for an echocardiogram is minimal:

• Pets can eat and drink normally before the appointment unless anesthesia is planned for another procedure on the same day
• Continue all current heart medications as scheduled on the day of the echo — do not withhold them, as they affect the measurements we're trying to evaluate
• The area of the chest where the probe is placed will be clipped; for very thick-coated dogs, slightly more fur may be removed for optimal image quality
• Sedation is rarely required — most dogs and cats tolerate the echo comfortably while lying still with gentle technician support

Most pets find the echo surprisingly relaxed — they lie on a comfortable padded surface with a technician providing gentle support, and the probe is simply pressed against the chest for the duration of the study. There is no pain involved. Cats especially tend to settle into a comfortable position quickly. Dr. D'Urso interprets findings in real time and will meet with you after the study to explain what was found, how severe any disease is, whether treatment is indicated, and what to monitor at home. A written cardiology report is provided for your records and your primary care veterinarian.

Echocardiography is completely safe — it uses sound waves with no ionizing radiation and can be repeated as often as needed for monitoring. It is safe for patients in early heart failure, for senior and geriatric pets, and for those on cardiac medications. There is no needle, no contrast agent, and no sedation required in the overwhelming majority of cases. The procedure is well tolerated even by pets in respiratory distress, though patients in acute decompensated heart failure are stabilized before a complete echo study is performed.