The causes of cardiac amyloidosis in the elderly may be primary, secondary, senile, and hemodialysis-related. 1. Primary: Due to proliferation and malignant transformation of single plasma cells, the ratio of heavy chain and light chain synthesis is imbalanced, resulting in an excess of light chains, most of which are λ-type light chains, which exceed the catabolic capacity of macrophages and aggregate to form amyloid fibrils. 2. Secondary: antigenic stimulation of primary diseases activates macrophages, and under the action of interleukin-1, hepatocytes produce a large amount of serum AA (SAA) protein, which disrupts macrophage function and cannot be completely degraded, leading to the formation of insoluble AA protein. 3. Age-related: The precapillary albumin isolated from the myocardium in some cases is not produced by cardiomyocytes, but its precursor is thought to be produced by extracardiac tissues and deposited in the lesion site through the blood circulation. 4. Relevance of hemodialysis: Normal human nucleated cells produce β2 microglobulin, 99.9% of which is filtered out by glomeruli, reabsorbed by renal tubules and broken down for metabolism, while renal tubules in patients with kidney disease are unable to break it down, resulting in a large amount of storage in the body. Elderly people with cardiac amyloidosis, should go to the hospital in time for examination and treatment under the guidance of the doctor.