Loses heart twice about Pennsylvania resorts (4)
I believe the answer is:
'resorts' is the definition.
(spa is a kind of resort)
'loses heart twice about pennsylvania' is the wordplay.
'heart' says to take the centre.
'twice' indicates the doubling of some letters.
'about' indicates putting letters inside.
'pennsylvania' becomes 'pa' ().
The middle of 'loses' is 's'.
's' duplicated is 'ss'.
'ss' going around 'pa' is 'SPAS'.
(Other definitions for spas that I've seen before include "Bath and suchlike" , "Mineral springs" , "Health resorts near springs" .)