Breakdown of У меня болит сердце, когда я вижу, как ты страдаешь.
я
I
ты
you (singular)
как
how
видеть
to see
Questions & Answers about У меня болит сердце, когда я вижу, как ты страдаешь.
Why do we use у меня instead of a word for "my"?
In Russian, the standard way to say a body part hurts is using the construction У + Genitive (who has the pain) + болит or болят (hurts/hurt) + Nominative (the body part). So У меня болит сердце literally translates to "At me, the heart hurts." You don't need a possessive word like моё (my) because у меня already shows whose heart it is.
Does болит сердце mean literal physical pain, or can it be emotional?
Both! Just like in English, this phrase can refer to a physical medical issue or, as in this sentence, deep emotional sympathy and sadness when seeing someone else in pain.
Why are commas needed before когда and как?
Russian punctuation strictly requires commas to separate clauses (parts of a sentence that have their own subject and verb). You need one before когда (when) to separate the "heart hurting" clause from the "I see" clause, and another before как (how) to separate the "I see" clause from the "you suffer" clause.
Why is the verb страдаешь in the imperfective aspect here?
страдаешь (you suffer) is imperfective because the speaker is talking about an ongoing, continuous process of suffering that they are watching happen in the moment, rather than a single completed event.