High-output cardiac failure in patients with multiple myeloma.

CARDIAC involvement in multiple myeloma has been associated with certain complications of severe or prolonged disease.1 Myocardial infiltration with amyloid has been well described as a cause of dilated or restrictive cardiomyopathy and congestive heart failure.2 , 3 The hyperviscosity syndrome induced by marked elevations of the circulating concentration of immunoglobulin in plasma-cell dyscrasias has likewise been associated with congestive heart failure.4 In addition, myocardial ischemia may occur as a result of one or more of these mechanisms combined with marked anemia in patients with multiple myeloma and underlying coronary artery disease. We describe three patients with well-defined multiple myeloma who were . . .