Upon crafting the Telltale Heart, the player who crafted it will lose 40 Health. If a player does not have enough health to craft the heart they will not be able to craft it (if they lose the health while crafting, crafting will reduce them to 1 health, after which they will most likely die to the other damage source, such as freezing or fire).
After a living player gives the heart to a ghost, the living player receives 80 Sanity, and the ghost is revived with an additional 25% (1/4) of their maximum health removed along with normal resurrection penalties. The health penalty received by a Ghost using this item can be removed through the use of a Booster Shot. Ghost Players cannot haunt the heart to revive, they must have it given to them by a living character.