Hi,
Welcome to HCM,
Your wife is having Rheumatic heart Disease which is due to streptococcal infection in childhood,but her 2D Echo report is showing only mild affection of AML&PML and no significant stenosis, we usually also see valve area,but as there is only mild MR surgery is not indicated and Penidura injection should be taken every 21 days AST. You must follow with your cardiologist regularly. At present no surgery is required but if any complication or stenosis develops then it may be required at suitable time.
Her cholesterol is mildly raised she can take care of diet and treatment as advised by your Physician.
You can discuss with your Physician about starting Storvas as this is used for reducing Cholesterol,taking care of diet and exercise one can recheck lipid profile and if not controlled drug therapy may be started.
Take care
Good Luck

Dear friend, welcome and thanks for entrusting your query here at HCM!
I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.

Did she have any symptoms to prompt an Echo evaluation? Any history of fever, joint pain, swellings/
She just has mild loose mitral valve which is likely a prolapse, a common condition in young females.
It is not at all serious and needs no treatment. The heart function is normal.
Her lipids are also acceptable.
Just a control on diet to avoid fatty, spicy food is enough with a follow up after 6 months.

You could ssek another cardiology opinion if she had any symptoms.

Penidure may not be needed if it is deemed to be a MVP (mitral valve prolapse).

I hope you are fully satisfied with the guidance I gave.
I would be glad to answer any further queries. May I request you to rate your experience here before you close.
Thank you and Good luck!