[3] The specific name cordifolia means "with heart-shaped leaves",[4] a characteristic shared by all taxa of Tiarella in eastern North America.

Some species have relatively large basal leaves with an extended terminal lobe (T. austrina, T. nautila, T. wherryi).

For example, Tiarella is sometimes confused with Mitella diphylla, a closely related species that occurs over a similar range and habitat.

[7][8] If a plant lacks sufficient evidence of flowering, the orientation of the hairs on the basal leaf stalk may be used to distinguish the two species.

Except for the stolon, the key features listed above are identical to those of Tiarella stolonifera, so distinguishing the two species may be difficult.

[14] In 1738, Linnaeus incorrectly cited the lectotype as "Mitella scapo nudo" in Hortus Cliffortianus,[15] but the error was corrected in Species Plantarum in 1753.

[17][27][28] For a long time, botanists considered the stoloniferous northern expression initially described by Lakela to be the typical variant of the species.

[18][20][13] In 2021, Guy Nesom provided strong evidence that the type specimen of Tiarella cordifolia L. was sourced in northeastern Virginia, a region where the stoloniferous form of the species was not known to occur.

Nesom went on to propose a major revision of the genus in which Tiarella cordifolia in the broad sense (labeled sensu lato below) consists of five closely related species:[29] In the strict sense (sensu stricto), Tiarella cordifolia L. refers to the non-stoloniferous form found along the East Coast of the United States.

[30][31] The taxonomy is especially popular in the southeastern United States where the diversity of Tiarella cordifolia sensu lato is greatest.

[12][32][33][34] The taxonomies of Lakela and Nesom agree insofar as the ability to produce stolons (or not) warrants separate species, but the two authors disagree with respect to stem leaves.

Lakela believed that the presence of stem leaves is "without taxonomic significance" whereas Nesom described two new species (T. austrina and T. nautila) based on that single character.

[37][38] In 1917, Oliver Atkins Farwell described a variety of Tiarella cordifolia sensu lato collected in Michigan the year before.

[39] Unlike the typical northern form of T. cordifolia, Farwell's variety had a small bract on the flower stem.

In eastern North America, Tiarella cordifolia sensu lato is wide-ranging, from northeastern Wisconsin across southeastern Canada to Nova Scotia, extending southward through the Appalachians into Alabama and Mississippi:[3][7][40] Tiarella cordifolia sensu stricto prefers moist forests, coves, rock outcrops, and well-drained bottomlands.

[12] Its range is narrowly confined to the East Coast of the United States from Maryland southward through Virginia and the Carolinas, continuing into Georgia.

[22] Based on individual state rankings, it may be inferred that Tiarella cordifolia sensu stricto is globally secure as well.

[43][44] It spreads well by rhizomes, unlike other cultivars of Tiarella, but lacks the invasive tendencies of many more commonly employed groundcovers.