Russia's heart falls out because he cuts it out, he believes that what his heart feels is a weakness so he just cuts it out, his heart mostly feels pain and regret. The reason why his heart hasn't healed and stopped falling out when it comes to meetings is because he cuts it out at the start of the day, because then he wont feel much of anything when it comes to painful world meetings. He started doing this after the Cold War. His whole look is an act.
JE LEEST
Hetalia Headcanons
FanfictionThese are some headcanons I made up myself sorry if some of them do exist I probably haven't seen them, Hopefully my headcanons wont be ones you have seen before (it is what I am aiming for). My headcanons can differ from being normal to depressing...