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They stated: "The new system describes 4 basic stages of heart disease and failure : " Stage A identifies patients at high risk for developing heart disease but that currently have no identifiable structural disorder of the heart (e.g., every Cavalier King Charles Spaniel without a heart murmur)." (So, Stage A means the dog does not have any MVD murmur but that its breed is at high risk for developing MVD.) " Stage B identifies patients with structural heart disease (e.g., the typical murmur of mitral valve regurgitation is present), but that have never developed clinical signs caused by heart failure

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Various diagnostic tools are available for early screening and diagnosis, which is essential given the substantial impact of ASD on the quality of life of affected children and their families

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