Hi, This is Dr Sameer RHD is a pretty common condition especially in India. Moderate MR with mild MS does not require surgery at present but it may progress in future & may require surgery. She will have mild breathing difficulty which is a normal disease natural history. Necessary medicine she is already taking. Pentids is a oral penicillin which will prevent further damage to valve & has to be taken life long. Palpitations are also very common & these type of patients may develope irregular heart rate called AF which she is also prone to develope as she has a P Mitrale in ECG which means enlargement of a chamber of heart (Left Atrium). Pregnancy is not contraindicated & can be proceeded with close monitoring of a cardiologist. But if the pulmonary pressure is high than the pregnancy will be high risk. We also give beta blocker to such patients. So remember to ask this with your cardiologist on your next visit. Rest don t worry, be in regular follow up with your cardiologist, do echo every 6 months & keep taking the medicines and she will be fine. Thanks