While the terminology isn't universal, VVCS makes a clear distinction between a Cardiovascular Screening Examination (CSE) and a (Cardiovascular) Breeding Clearance Examination (BCE).   Both examinations are conducted by a board certified cardiovascular specialist, but there are significant differences in sensitivity, for detecting cardiac abnormalities, and cost.

 A Cardiovascular Screening Examination is nothing more than a careful cardiovascular physical examination.  The most important part of the examination consists of auscultation, listening with a stethoscope for the detection of abnormal heart sounds such as murmurs.  This examination is appropriate at any age and is suitable for determining an individual's cardiovascular health at the time.  It cannot rule out minor cardiac abnormalities, heart diseases that only manifest physical abnormalities after a year of age, or congenital defects that notoriously do not manifest physical abnormalities at all until/unless they are severe.  Examples of the latter include tricuspid dysplasia, mitral or tricuspid valve stenosis, and atrial septal defect.  Young animals can be screened using this examination to determine whether they are suitable for sale with reasonable assurance of cardiovascular health.  VVCS issues a report with this examination that can be presented to a prospective pet owner, indicating the outcome of the exam and the suitability of the pet for sale.  The report stipulates that mild abnormalities may not be detected and that perinatal disease may still develop after the examination.  (Subaortic stenosis, for example, is a condition that may not be detectable at birth but increases in severity over the first 6-12 months of age.)  VVCS WILL NOT issue Orthopedic Foundation for Animals (OFA) or ACVIM Registry of Cardiac Health (ARCH) documentation with this examination until such time as these organizations make a clear distinction between this level of evaluation and an evaluation that includes an echocardiogram.  A CSE is relatively inexpensive, can be performed quickly, and can be used to screen litters of animals.  However the exam must be performed in a quiet, secluded environment and it may be necessary to sedate an individual if required by the cardiologist.  A panting, squirming puppy can sound like it has a murmur, when it doesn't. Alternatively a significant  cardiac abnormality can be missed due to the additional background noise caused by an uncooperative patient. 

A cardiovascular Breeding Clearance Examination at VVCS includes the same physical examination as a CSE and also requires an echocardiogram with Doppler echocardiography.  Additional tests may also be necessary depending on the circumstances.  A BCE is suitable for animals intended for use as breeding stock and may take an hour or more because of the Echo/Doppler study involved.   Obviously this is more extensive and expensive and a BCE is more sensitive to detect diseases that do not manifest abnormalities on physical examination.  VVCS will generate OFA or ARCH documentation for this examination, but the animal must be greater than one year of age.   A BCE rules out congenital heart disease to the best ability of the cardiologist. This can't be done without an echo/Doppler.

Some tips for breeders:  

• Do not consider an animal for a breeding program that has not had a breeding clearance examination.  Time and again we've found serious congenital heart disease in grand champions!  After such a serious investment in time, energy, and money, this is a heartbreaking experience for everyone. 
• Results of tests vary with circumstances.  Don't bring an animal for either a CSE or BCE that isn't healthy in other regards.  A fever, anemia, or pregnancy can result in a substantial heart murmur in an animal with an otherwise normal cardiovascular system. 
• If an animal is found to have congenital heart disease, then related animals are suspect genetic carriers!  This includes progenitors, siblings, offspring, and other related individuals.  Optimally you need to find the source of the abnormality, i.e. the individual(s) originating the defect, and discontinue related individuals from the breeding program.