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I strongly recommend you get her spayed instead of giving her the pill (Perlutex, I assume).
My Jade had surgery less than a week ago...sorta emergency as her mammary glands were swollen, and she's been on the pill.
The vet said "the uterus didn't look good at all" and she "was full of cysts".
Edit: Just saw that she might have heart problems. Beans (RB) had a congenital heart disease and she was on the pill as long as she lived because putting her under anesthesia was too risky. Beans didn't have any problems with being on the pill.
If Snoopy has a heart disease, I'd take the chance on the pill.
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I think I'd got for the echo so I knew what the deal was with Snoopy's heart - you can then decide the best way forward from there. Hugs and kisses to your dear little cat