。
My poor heart aches.
Literal
I [of-の] pitiful heart [topic-は] aches.
哀れな ('pitiful, pitiable, forlorn') is a literary/emotional na-adjective. 心 means 'heart' in the emotional sense. 痛む ('to ache, to hurt') is used for physical and emotional pain. The whole sentence has a distinctly poetic tone — sounds like a line from a song or literary text.