A comic opera, The Murder of Comrade Sharik by William Bergsma (1973), is based on the plot of the story. The story was filmed in Italian in 1976 as Cuore di cane and starred Max von Sydow as Preobrazhensky.
A 1988 Soviet movie, Sobachye Serdtse, was made (in sepia) by Vladimir Bortko. A number of sequences in the movie were shot from an unusually low dog's point of view.
In 2007, Guerilla Opera staged the premiere of Heart of a Dog, an opera by Rudolf Rojahn, directed by Sally Stunkel. In 2010, the second production was directed by Copeland Woodruff.
In 2010 De Nederlandse Opera staged the premiere of A Dog's Heart, an opera composed by Alexander Raskatov, directed by Simon McBurney. This was staged again by the Opéra de Lyon in January 2014.
In March 2011, Heart of a Dog was staged at the University of Leeds, directed by James Ahearne and Matthew Beaumont.
A new musical adaptation of Heart of a Dog was developed in Australia and was to premiere in May 2013, written by Jim McGrath, composed by Marc Robertson and directed by Nick Byrne.