Primary amyloidosis, systemic senile amyloidosis, isolated atrial amyl
oidosis, and transthyretin isoleucine 122 amyloidosis frequently invol
ve the heart. Amyloid fibrils infiltrate the myocardium, impairing ven
tricular contraction and relaxation. The clinical manifestations of ca
rdiac infiltration in these disorders are protean, though congestive h
eart failure and arrhythmias are most common. Treatment of cardiac amy
loidosis is directed at the underlying cause and at relief of symptoms
. Heart transplantation is not a viable treatment option for patients
with primary amyloidosis; its role in the other amyloidoses has not be
en established. The prognosis of patients with cardiac amyloidosis var
ies and is largely determined by the underlying disorder responsible f
or amyloid infiltration.