Evidence of cardiac amyloid is present in up to
90% of cases of primary and multiple myeloma-associated amyloidosis.
Cardiac amyloidosis is also found in association with lymphoma, rheumatoid
arthritis, tuberculosis, osteomyelitis, and bronchiectasis. The predominant
clinical features are those of cardiac failure, tachypnea, orthopnea, decreased
exercise tolerance, elevated jugular venous pressure, pulmonary edema, and
hepatic distension. The ECG may show bundle branch block or rhythm
abnormalities. The chest radiograph may show cardiomegaly (secondary to a
pericardial effusion) or pleural effusions. The ventricular failure is often
refractory to medical management.