Answer:
The story's title says that the heart is a "tell-tale" sign. It refers to the beating heart that eventually drives the narrator to confess his crime. The reader is led to believe it is the beating of the old man's heart he hears, which is impossible, since he is dead and in pieces. I think it is a perfect title. It leaves us wondering if, in his insanity, the narrator hears the old man's heart, if he feels guilt over the crime and hears his own heart, or a little bit of both. In all of those options, the heart is telling the tale.
Hope this helps :)
