Connective tissue disorders and certain infections are among the possible culprits. The most important question though is how leaky are the valves. Another question is whether there is pulmonary hypertension. A good echocardiogram can answer these questions. In addition to seeing a cardiologist, your daughter should see a rheumatologist to investigate the cold and discolored hands further.
Information provided here is of a general nature.
Specific diagnoses and treatments can only be made by your doctor. Information contained within this forum is intended solely for general educational purposes and is not intended nor implied to be a substitute for professional medical advice relative to your specific medical condition or question. Only your physician can provide specific diagnoses and therapies. All rights reserved.