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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

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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