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Biomed Opt Express 12(7):42494264

Specifically, this is what the ACVIM states about ultrasounding cavaliers once a mitral valve murmur is detected: "In small breed dogs with typical murmurs, echocardiography is recommended to answer specific questions regarding either cardiac chamber enlargement or the cause of the murmur if those questions are not answered adequately by auscultation and thoracic radiography." Note that the only "baseline" that the ACVIM recommends for cavaliers with new murmurs is an x-ray and not an ultrasound, as long as the cardiologist is satisfied that the stethoscopic exam and the x-ray confirm the cause of the murmur

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Meier JJ, Gethmann A, Gotze O, Gallwitz B, Holst JJ, Schmidt WE, et al