multiple mild leaky valves, mild pericardial effusion and mild carotid stenosis

Hello, I am a 40yo smoking female. I was just dx with mild emphysema. I am going thru some very tough times and am feeliing sicker and sicker. I have p.o.t.s, likely small fiber neuropathy, sleep maintenace insomnia, spinal/cervical stenosis (lots of pain), plus a few other things that are being tested... intestinal pain and bloating.

I had a seizure a few weeks, and a follow up echo to the one last december. The last one showed mild aortic insufficiency and trace tricuspid regurg plus tiny pericardial effusion.

The new one showed mild mitral regurg, mild sclerosis of aortic valve, mild aortic insuff, mild tricuspid regurg, and small (.7) anterior pericardial effusion. I also had carotid ultrasound showing mild stenosis.

I go in for another echo next week. What can I expect? I get out of breathe very easily now, and avoid stairs as I find it too taxing, but is that the emphysema or the heart causing the 'out of breath' feeling? I am extrememly fatigued as it is with the autonomic stuff, and I pass out and have seizures sometimes, I even felt like a had a stroke last week but didn't get to talk to my doc. When i raise my arms i see stars, or when I squat as well. But this has been going on for years. The breathlessness is more recent. 

But will I have to have valves replaced in the future with the mild aortic regurg? Do I have mild heart issues now as well? 

Thanks very much for your input. I don't see my cardio until next week and I am getting very stressed about it. I am sure he is repeating echo to see if there are more changes, but it is worrisome. Thanks!!