<s>[INST] Hi doctor, My husband was just diagnosed with congestive heart failure with 25% ejection fraction. They also found an artery 100% blocked, but his own body made another vein and they discovered it is viable, so no bypass surgery is needed. They also discovered his mitral valve is stiffened, and not working. He has some kidney damage also. We are going to have a scope done, and I guess that will determine how to fix the mitral valve. Will they do another test to determine the cause? He has told them he used some steroids during his bodybuilding days, and he drinks occasionally. But, he drinks every night and has used mild steroids up until this happened. They are going to do a test that would determine how it was caused. Could it be due to a virus or abuse? I am just trying to be educated before we go to the next visit. My husband is not always honest with the doctors. [/INST] Hi. Thanks for the query madam. Good to know you are worried about your husband. Yes, alcohol and steroids do cause harm to the heart. Make sure your husband never uses these suicidal drugs again, as now he has an ejection fraction of only 25%. Coming to the mitral valve, it depends upon how much it has narrowed. If severe narrow, then options are either surgery to change the valve or percutaneous mitral balloon valvotomy (PMBV), in which the mitral valve is widened by inflating balloon in the valve. If not severely narrowed, then only medicines of heart failure are sufficient for your husband. Comply with the doctor's advice and medicines. Have vaccination against influenza done yearly, and also pneumonia five-yearly. If EF is 25% and not improving, then have a device installed in the heart called ICD (implantable cardioverter-defibrillator), to save from sudden cardiac arrest. </s>