I think it is in reference to something that constantly eats at you. Nothing you can get rid of. Something that you can't always see, but it is always there.
I could be really wrong, but I always took it as nothing to hide. On your sleeve, it is exposed for everyone to view. And sometimes by doing that it makes it really easay for people to fuck with. dunno....
yeah, i agree with superoachio (sp?) i always heard it as, "someone who wears their heart on their sleeve." i took it to mean someone who is very open with their emotions and doesn't try to hide anything...but yeah, i think it may have negative connotations...
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