Rheumatoid nodules in the heart are unusual specific manifestations of rheumatoid arthritis. This paper describes three cases in which these nodules were found at necropsy. The patients were women with long histories of rheumatoid arthritis, two of whom had significant but unexplained congestive cardiac failure. The rheumatoid nodules were present in the patients' myocardium and in one patient's pericardium. We suggest that in patients with rheumatoid arthritis with severe but unexplained cardiac failure, the possibility of rheumatoid nodules in the heart should be considered.