What is a ‘black heart’? The condition Ray J says may kill him next year

Ray J is fighting for his life after being told his heart is on the line — and has seemingly told fans he expects to die next year.

“This is black. This is, like, done,” the 45-year-old R&B singer said in an Instagram livestream on Tuesday, pointing to his chest. “2027 is definitely a wrap for me.”

The “Sexy Can I” artist blamed his health issues on heavy substance use, admitting: “I f—ked up.”

“I thought I was big so I could handle all the alcohol, I could handle all the Adderall, I could handle all the drugs — but I couldn’t,” he admitted. “It curved my time here.”

The grim update from Ray J — whose real name is William Raymond Norwood Jr. — comes on the heels of news earlier this month that he’d been hospitalized with a severe case of pneumonia after experiencing “heart pains.”

“My heart’s only beating 25%,” the “One Wish” hitmaker said in another Instagram video after returning home over the weekend, adding in the caption that he “just almost died.”

Still, Ray J said he’s trying to stay optimistic about his prognosis.

“As long as I stay focused and stay on the right path, everything will be all right,” he said. “My health is not OK, so I thank everybody for supporting and praying for me through everything I’ve been in the hospital.”

Here’s what you need to know about the so-called “black heart” that’s plaguing the singer songwriter.

What is a black heart?

Heart tissue turning black is most commonly linked to alkaptonuria, a rare genetic metabolic disorder in which the body can’t break down homogentisic acid.

Over time, this acid builds up in connective tissues — including heart valves — causing discoloration and other complications.

But “black heart” can also refer to tissue death or necrosis caused by a severe lack of blood flow or oxygen.

It’s not clear exactly what Ray J is suffering from, but heavy and chronic substance use can lead to tissue damage in the heart.

Stimulants like cocaine and Adderall can severely narrow blood vessels, restricting blood flow and starving tissues of oxygen and nutrients, which can ultimately lead to necrosis.

“[I] f—ked my heart up on the right side,” Ray J said in the Instagram video. “It’s, like, black … It’s like a gun.”

Can you treat a black heart?

Ray J told TMZ on Thursday he’s been put on strict bedrest and is now taking eight different meds as doctors attempt to stabilize his failing heart and prolong his life.

Among the drugs are Jardiance and Entresto, prescriptions typically used to reduce the risk of death and hospitalization in adults with chronic heart failure.

He’s also on Lipitor, a popular statin meant to slow cholesterol production and help prevent heart attacks and strokes.

Doctors have warned Ray J to brace for the possibility of needing a pacemaker or defibrillator, though he won’t know for sure until his follow-up appointment in two weeks.

In the meantime, their message was blunt: no drinking, no smoking.

The father of two told TMZ the lifestyle changes haven’t been easy, but said he’s determined to turn things around so he can be present in his children’s lives.

He is currently barred from seeing them due to a criminal protective order issued after his November 2025 arrest, when he allegedly pulled a gun on his estranged wife, Princess Love, during a livestream.

Not being able to see his son and daughter, he told the outlet, “took me down” and “made me realize I need to change my ways of living.”

But as Ray J works toward recovery, he’s not relying solely on Western medicine.

The “I Hit It First” singer said he may travel to Haiti to “do some voodoo,” claiming that after doing his own research, he believes “they got the cure.”

“If I come out of this, I’ll be stronger and a better person,” he told fans.