The narrator's inablility to bear the beating of the old man's heart foreshadow's the old man's death by the narrator's hand.
"...... there came to my ears a low, dull, quick sound, such as a watch makes when enveloped in cotton. I knew that sound well, too. It was the beating of the old man's heart. ...It grew louder, I say, louder every moment! --do you mark me well I have told you that I am nervous: so I am. And now at the dead hour of the night, amid the dreadful silence of that old house, so strange a noise as this excited me to uncontrollable terror."
The Tell-Tale Heart