Thanks for the query to H.C.M. Forum. Ventricular septal defect
( V S D) , the presence of one hole ( tiny membranous ) is one of the most common CONGENITAL heart defect.
In your sister case it is from left to right and usually this is common site.
So this is not responsible for any hypertension
or headache ( till now).
Only one thing mentioned in ECHO is that take care of INFECTIVE ENDOCARDITIS
So avoid any type of infection of heart.
PAH & L V are also normal.
High B P is due to the nature and habit of this patient.
When she is having any palpitation
her blood pressure shoot up at once .
When in emotion same thing happens.
Use mild degree ( clonazepam
0.25 mg ) drug and she will get relief within a short time.
Hope I have answered your question.
If further any question I will help.