Lead guitarist Chris Degarmo wrote in the liner notes to the Japanese Edition of the album: "'Hand on Heart' is a song about pledging a loyalty to someone, and finding someone who made a difference. Geoff (lead singer Geoff Tate) wrote the lyrics to this and it's about someone that makes a difference. It's about promising love and faithfulness."
Geoff Tate described this to Hit Parader as "a relationship song," adding, "We've tried to give a little different angle on the old love story, and I think we've done it fairly well."
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