Urgent Question - Heart Failure

[Student of Knowledge]

I would really appreciate it if the health professionals in this site gave me a little helping hand with this case. 

A 60 year old patient with myeloma for 15 years now advanced, no amyloidosis, severe anaemia and bone marrow failure, immune suppression
Investigations revealed: Urine protein and paraprotein very very high, beta 2 microglobulin v. high, patient eventually dies of heart failure. why?

Assumption: high-output congestive heart failure due to anaemia and the diffuse bone marrow infiltration not related to any amylodosis.

Thanks in advance.

[Admin]

It's high-output congestive heart failure due to myeloma it self not anemia!
because increased concentration of circulating protein in the blood can increase the volume of plasma that the heart has to pump around, and this can cause 'heart failure'.

It can also increase the thickness of the blood (viscosity), particularly if it is a type of myeloma resulting in production of a large antibody (IgM or IgA rather than IgG).

Normal blood is about twice as viscous as water, whereas blood in this type of myeloma may be five or six times more viscous than water.

Dr.Mahdi