A case of cardiac amyloidosis, which was recognized as an ischemic change by exercise Tl-201 myocardial scintigraphy, was studied. The case was 41 year-old woman, whose initial symptom was pretibial edema and died of ventricular fibrillation. Ischemic change was ascertained by the treadmill exercise test and exercise Tl-201 myocardial scintigraphy, however, the significant coronary stenotic lesion was not detected by coronary angiography. Our data suggested that ischemic change may be related with the disturbance of microcirculation caused by deposit of amyloid in the vessels and/or around the vessels from the pathological findings.