This is a clever little piece of design by Polish design company Syfon Studio. It employs a conceptual use of symbolism in the fact that an aerial view of a grand piano looks like a heart. It is this kind of simple, conceptual, image based design (althought type is also considered here) that I love.
I also like this because I love Chopin...
In terms of printing, the t-shirt is likely to be a spot colour (red and black) screen print due to the block colour. A 4 colour process print would be a waste of time, ink and money!
Be seeing you!