A deadly earthquake which killed six people and left thousands homeless in northeast Italy also caused traumatic damage to much-loved churches, belltowers and castles that dot the historic region.

"There's damage to the psychological heritage here," said Giancarlo Rivelli, one of a team of engineers helping firefighters and civil protection agency officials to inspect buildings after the quake and dozens of aftershocks.

"People identify with these buildings. They're part of their life," he said.

As he rushed out of his barracks in the town of Finale Emilia at the epicentre of the quake to help local residents, an emergency official said: "All the churches have been hit, even the cathedral! It's a tragedy."

"It's a huge treasure that has been laid to waste," said the official, one of a group of dozens in reflective overalls dealing with crowds of homeowners coming to report damage to their property and going on site to inspect.

The earthquake and a powerful aftershock that followed it on Sunday brought down the belltower in Finale Emilia -- the shocking image of the tower was on the front pages of many newspapers on Monday as Italy counted the losses.

The cathedral in the town also lay in ruins and turrets of the 13th century Castello delle Rocche were extensively damaged -- their bricks splayed out as if the ancient fortress had been hit by a barrage of cannon fire.

"At the moment we're just dealing with the emergency. We're looking at all the homes to make sure that people can live in them. The reconstruction of the churches has to take second place unfortunately," said the emergency worker who requested anonymity as he was not authorised to speak to the media.

In villages and towns across the flatlands of the Emilia Romagna region most of the modern two-storey homes remained intact while Art Nouveau villas, rustic farmhouses and churches were brought down by the 5.9-magnitude quake.

The churches, many of them dating as far back as mediaeval times, were a popular meeting place -- a social reference point at the historic heart of spread-out settlements in the region's farmlands and industrial parks.

"It makes you want to cry," said Arcangelo Martini, an employee of the local Lamborghini factory, as he looked at the shattered town hall in Sant'Agostino, next to a ruined bell tower whose clock was stuck at 4:05 -- the time the quake struck.

"There are so many monuments here. Such a heritage. It's depressing. How can we abandon things like this in Italy?" he said.

"They're never going to get rebuilt. They'll just impose more taxes."

Another local, Maurizio, broke down in tears outside a blue tent set up by emergency workers in Finale Emilia: "If you compare what it was like before to what it is like now. The castle, the churches..."

Antonia Pasqua Recchia, an official from the culture ministry, said: "The state of cultural heritage in the area is even more dramatic than it looks."

The ministry said the damage was "significant" and culture experts have been inspecting buildings alongside firefighters and emergency workers."

Museums in the historic city of Ferrara -- a UNESCO World Heritage site just a few kilometres (miles) from the quake -- have been shut as a precaution.

Among those traumatised by the damage are local architects and engineers who have seen the fruits of their labours ruined.

Claudio Fabbri shook his head as he looked at the ruins of the 16th-century Ghisilieri Oratorium, an elaborate chapel used for concerts in the village of San Carlo where the frescoed vault has caved in.

A painstaking eight-year restoration was partly funded by a campaign on social media networks and contributions from local residents.

"We were mentioned in the news as a good news item. Look at it now," said Fabbri as he clambered over bricks covered in fragments of fresco.

Firefighters only managed to rescue a painting hanging above the chapel's altar before the start of a downpour that would have destroyed it.

The statues of angels decorating the altar, which once gazed at the glorious vault commissioned by a local aristocrat, now stare out at an angry sky.