This sourcebook for Heart: the City Beneath gives characters from the Spire: The City Must Fall RPG the opportunity to go mad and die in the nightmare realm below their city. Each character class from Spire is distilled down into an easy-to-use origin that reflects the challenges faced when fleeing to the Heart, and the player group will work together to get away from their shadowy previous employers and the security forces of Spire by playing through their Fall.

The book also explores Derelictus - the barrier between Spire and the Heart - allowing fleeing Spire characters a chance to get caught by hungry ghouls in Grist, fed to pigs in one of the cramped swine farms, or captured by black magicians in Ebony Row.

Finally, Burned and Broken also offers rules and guidance for playing games that bring the occult revolutionary theme of Spire into the Heart RPG. Additional advances for Ministers, a list of plot hooks and active Ministry operations, and the new calling - Minister - allow players to overthrow the cruel dominion of the high elf government from deep beneath the surface of the world.