Cardiac amyloidosis is an infiltrative cardiomyopathy, typically conducting to heart failure with preserved ejection fraction. There are several causes for the disease, from which two can already be seen in the young patient and are due to either genetic mutation or neoplasia. A third, non genetic cause, typically affects older patients (previously called senile amyloidosis) and appears to be much more prevalent than initially reported. A careful initial work-up and a high index of suspicion are important to detect as early as possible the disease, as it is associated with a poor prognosis in the late stage. A standardized diagnostic approach has been proposed with the use of bone scintigraphy, recently recognized as a sensitive diagnostic tool for this type of amyloidosis. With new disease modifying therapies recently becoming available, a more active diagnostic strategy is justified.