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Fish are affected by a wide range of cardiovascular conditions including infectious (e.g., viral, bacterial, fungal, and parasitic) and non-infectious (e.g., congenital, degenerative, environmental, idiopathic) diseases. There is an overall a lack of knowledge and information in the literature regarding both normal cardiac parameters and the cardiovascular effects of anesthetic agents, such as isoeugenol, on fish including koi carp (Cyprinus carpio). Koi carp are popular ornamental fish found worldwide as display animals in private collections, zoological institution and aquariums. A cross-over study evaluated echocardiography in 40 adult koi carp and determined ultrasound to be a non-invasive method for cardiac evaluation under both manual restraint and anesthesia with isoeugenol (AQUI-S) at 50 ppm. Mean heart rate was significantly higher in anesthetized fish compared to manually restrained fish. Respiratory rate decreased significantly in anesthetized fish compared to manually restrained fish. Mean ejection fraction, stroke volume, and cardiac output were significantly lower in anesthetized fish than in manually restrained fish. Overall poor measurement agreement and correlation were found between veterinarians measuring the same echocardiography study for each fish. This study provides the first description of echocardiography in koi carp and demonstrates significant differences in cardiopulmonary parameters under manual restraint compared to anesthesia with isoeugenol. [ABSTRACT FROM AUTHOR]