The most common infiltrative cardiomyopathy is amyloidosis, which by electron microscopy consists of rigid, nonbranching fibrils lying in between the myocardial muscle cells (see figures 74c, 74d, 77b). There are two kinds of amyloidosis:

1) primary in which there is no coexisting disease, except in some cases of multiple myeloma (a disease of the plasma cell, which proliferates out of control to crowd out the normal bone marrow cells resulting in anemia and other abnormalities).
2) secondary amyloidosis may be associated with chronic diseases like tuberculosis, or rheumatoid arthritis. The heart becomes stiff as a result of the infiltration of the amyloid into the heart muscular tissue leading to restrictive heart mechanisms of contraction.

Figure 73a Figure 73b	Figure 74a	Figure 74b	Figure 74c	Figure 74d
Figure 77a	Figure 77b	Figure 77c	Figure 77d	Figure 77e

The echocardiogram shows thickening of both the right and left ventricular muscle (to see the entire photographs of figures above click on: 73a, 73b, 74a, 74b, 74c, 74d, 77a, 77b, 77c, 77d, 77e).

The prognosis is poor and most treatments are ineffective.

In addition to an EKG, chest x-ray, and Doppler echocardiogram, cardiac catheterization is necessary to document the diagnosis with special attention being focused on the venous pressure, which is characteristically elevated considerably above normal, with an initial dissent and then a plateau.

While the left systolic ventricular pressure is normal,the left ventricular diastolic pressure shows the same abnormalities as the right ventricular blood pressure (see figures 74a, 77d, 77e).