Although involvement of the heart by malignant lymphoma is relatively common, it is unusual to be detected premortem. We report a case of Hodgkin's lymphoma who presented with systemic signs and symptoms including abdominal distension, weakness, pallor, chills and fever, hepatosplenomegaly and generalized lymphadenopathy as well as signs of heart failure. Echocardiography revealed lucent myocardial lesions, pericardial effusion, and left ventricular hypertrophy. Right cervical lymph node and bone marrow biopsies established the diagnosis of nodular sclerosis Hodgkin's lymphoma with bone marrow involvement. After 14 periods of chemotherapy, systemic and cardiac abnormalities improved. To the best of our knowledge, Hodgkin's lymphoma primarily presenting with myocardial metastasis and heart failure is not previously reported.