I Have Severe Mitral Valve Regurgitation. I Recall Having A

I have severe mitral valve regurgitation. I recall having a heart murmur most of my life. My primary was concerned in 2016 and had me take an echocardiogram which said moderate to severe regurgitation. In February, after a collapse, I took another echocardiogram with severe regurgitation. What causes this? Stress over the years? Also, can holistic herbal medicines fix or do I need surgery to repair and/or replace the valve?