One site may be lost, and the other has only 16O healthy plants. A third known Lincoln County site was destroyed. Rutherford County also supported another site, but it was eliminated by road construction. In addition to its known range, the plant may occur in isolated areas in northwestern Gaston County, western Iredell County, and Yadkin County, all in North Carolina. Dwarf-flowered heartleaf grows in acidic, sandy loam soils along bluffs and nearby slopes, in boggy areas adjacent to creekheads and streams, and along the slopes of hillsides and ravines.
Soil type is the most important habitat requirement.
The species needs Pacolet, Madison gravelly sandy loam, or Musella fine sandy loam soils to grow and survive. Provided the soil type is right, the plant can survive in either dry or moderately moist habitat. For maximum flowering, the plant needs sunlight in early spring. Creekheads where shrubs are rare, and bluffs with light gaps are the habitat types most conducive to flowering and high seed production. Seed output is lowest in bluff populations with a lot of shade.