Malignant Heart is one of the Boss Trophies in Diablo 4 that was previously a Lair Boss Key but has changed since Season 13 updates.
This Boss Trophy is tied to the Echo of Varshan, who players may challenge within the Malignant Burrow for a chance to obtain it.
While defeating Varshan is one of the main ways to get a Malignant Heart, there are also other methods to farm this item across endgame content.
How To Get Malignant Heart?
Malignant Heart is commonly obtained by defeating Varshan and opening his hoard after using a Lair Key in the Malignant Burrow.
You can also obtain additional Malignant Hearts through Nightmare Dungeons, World Boss encounters, and Mercenary Bartering available in The Den.
Malignant Heart is only available in Torment difficulties and will not drop at all before reaching endgame progression content.
Malignant Heart Uses
Malignant Heart is used in the Horadric Cube through Amalgamation, where five copies are combined into a single reward from Varshan’s unique drop table.
This allows players to convert excess Boss Trophies into targeted loot instead of relying only on direct boss drops from encounters.
It replaces the older hoard-opening system, turning Malignant Hearts into a currency for controlled reward rolls tied to Varshan.
Varshan Unique drops include the following:
All Classes
- Shard of Verathiel
- Razorplate
- Barbarian
- 100,000 Steps
- Overkill
Druid
- Autumnal Crown
- Greatstaff of the Crone
Necromancer
- The Hand of Naz
Paladin
- Arcadia
- Seal of the Second Trumpet
- Wreath of Auric Laurel
Rogue
- Death’s Pavane
- Eaglehorn
- Pitfighter’s Gull
Sorcerer
- Levin Grasp
- Onyx Soul
- Raiment of the Sea
Spiritborn
- Balazan’s Maxtlatl
- Wound Drinker
Warlock
- Ae’grom’s Schism
- Bindings of Attrition
- Seal of the Ophanim
- Thrice-Woven Nightmare
Verdict
Varshan can be quite a tough enemy to defeat due to the minions that he spawns to sustain himself but the rewards earned are worth the trouble and you don’t lose anything if you fail.
Malignant Hearts provide an alternative way to obtain items from Varshan by converting them through the Horadric Cube instead of relying purely on direct drops.
This makes them useful for targeting specific rewards while still allowing players to naturally farm Varshan for additional Unique items over time.
