Because there are no symptoms (usually) until the condition is advanced, the doctor or cardiologist will periodically have you take an echocardiogram. That could be every 6 months or 1 year depending on degree of the condition.
If you are having chest pains, that could be a heart problem, but not necessarily due to valve insufficiency. It could be ischemia (lack of blood flow) due occluded vessels. Dizziness could be low blood pressure and numerous other causes. You should get a checkup to rule out a heart disorder.
I do have symptoms which is what prompted me to get things checked out. I have chest pain, dizziness, among other symptoms which made me think I was having a heartattack.
You mention monitoring. Are you saying I need to keep it monitored? If so is that just regular heart checkups with a specialist or is this something my regular doctor can do?
Without symptoms most people don't need treatment. The symptoms if severe can be shortness of breath, muscle fatigue, chest pain, and signs that develop when severe (or less) can be an enlarged heart, congested heart failure, faster than normal heart rate, etc.
Whether or not valve regurgitation progresses depends on the underlying cause. Sometimes when a person ages there is some calification that causes mild leakage and a slow progression, if any. Requires monitoring.