Most Tier 3 items can be acquired through quests given by Mataus the Wrathcaster, who can be found in Light's Hope Chapel in the Eastern Plaguelands. Before the quests become active, Echoes of War must be completed. The quests require several crafting materials, [Wartorn Cloth Scrap]s (which drop from Trash Mobs in Naxxramas) as well as a token from a boss in Naxxramas The only exception is the [Plagueheart Ring], which drops directly from Kel'Thuzad in Naxxramas