Cardiac amyloidosis is rare, but should be considered in the differential diagnosis of any patient with congestive heart failure who does not have evidence of ischemic heart disease. The diagnosis is more likely in patients with increased wall thickness and normal chamber size on echocardiogram, low voltage on the electrocardiogram, and evidence suggesting a multisystem disease. Amyloid proteins are varied; the most common are AA, AL and transthyretin. The clinical features differ and are largely determined by the underlying disease responsible for the amyloid infiltration and of the organs involved. The specific type of protein must be determined as the prognosis and treatment vary among the different types of amyloidoses. Systemic amyloidoses are life-threatening diseases but making an early diagnosis in connection with today's more specific treatment may modify the course of the disease.