A 48-year-old man presented with worsening dyspnea and was found to have reduced left ventricular ejection fraction and hypertrophy. Tests ruled out amyloidosis but showed monoclonal free light chains and cardiac light chain deposition. Biopsy demonstrated light chain immunoreactivity in fibrotic areas, confirming light chain deposition disease. Medical management was initiated but the patient deteriorated and died while being evaluated for heart transplantation.