While there are 32 Malignant Hearts that you are able to acquire in Season 1 of Diablo 4, the Wrathful Malignant Hearts are by far the most useful. They can be socketed into any ring or amulet, regardless of their classification. They also grant the most beneficial bonuses to the player, making them highly sought-after in Sanctuary.
However, perhaps the most desired Wrathful Malignant Heart in Diablo 4 is the Caged Heart of Creeping Death.
This particular Malignant Heart offers the following bonus when socketed into jewelry: “Your damage over time effects are increased by [30 to 40] percent for each different Crowd Control effect on the target. Unstoppable monsters and Staggered bosses instead take [110 to 130] percent increased damage from your damage over time effects.”
Damage over time is a massive part of most builds in Diablo 4, so being able to deal more of it is extremely useful.
Getting the Caged Heart of Creeping Death in Diablo 4
Unfortunately, like all other Malignant Hearts in Season 1, you cannot guarantee yourself the Caged Heart of Creeping Death through any one method. Instead, you have to rely on RNG and hope that it drops for you. Luckily, you can be playing on any World Tier as any class to see the Wrathful Malignant Heart drop, so there are no real restrictions.
Your best chance at finding the Caged Heart of Creeping Death is to kill Malignant Monsters. Wrathful Malignant enemies have the best odds of dropping the heart, and they are primarily found in Malignant Tunnels. You can use a Wrathful Malignant Invoker on at Outgrowth at the end of the tunnel to ensure yourself that a Wrathful Malignant enemy appears.
In addition to killing enemies, you can also try to craft the Caged Heart of Creeping Death. However, this is far less likely and will require tons of resources. If you want to try it, head to Cormond’s Wagon and craft an Uncertain Heart. This is done for 20 Brutal Malignant Ichor, 20 Devious Malignant Ichor, 20 Vicious Malignant Ichor, and 1,000 gold.
Upon crafting an Uncertain Heart, it has a small chance to be the Caged Heart of Creeping Death. I recommend waiting until you are at a much higher level to craft Uncertain Hearts, as the Wrathful Hearts scale with your character level.
At the end of the day, you will have to hope that the Diablo gods are on your side if you want to land the Malignant Heart.