A 52-year-old male patient presented with resistant congestive heart failure. Echocardiographic findings revealed increased right ventricular (RV) wall thickness in conjunction with concentric left ventricular (LV) hypertrophy, LV systolic dysfunction and a granular sparking myocardial appearance. Doppler assessment showed a restrictive LV and RV diastolic filling pattern. These echocardiographic features combined with low voltage of the electrocardiogram is highly suggestive of cardiac amyloidosis. The diagnosis was confirmed by cardiac catheterization and endomyocardial biopsy.