What can you conclude from these findings?

A heart murmur is detected when Josephine, teenage girl, who has sought medical care because of feeling of chronic fatigue. Her radial pulse is rapid and weak. An echocardiogram and coronary angiography reveal that she has a ventricular septal defect and mitral stenosis. Her ECG indicates sinus tachycardia, and laboratory findings indicate a very high plasma cholesterol concentration with a high LDL/HDL ratio. What can be concluded from these findings?