Binding of Isaac: Rebirth Wiki
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(except in Rebirth)

Have a Heart is challenge #25. Isaac begins the challenge with Collectible Charm of the Vampire iconCharm of the Vampire and 12 Red Heart containers, but only one of them filled. Unlike in many other challenges, Treasure RoomTreasure Rooms and ShopShops are available. The goal is to defeat Boss Mom's Heart ingameMom's Heart / Boss It Lives ingameIt Lives.

Difficulty[ | ]

Charm of the Vampire is the main way to fill Isaac's Red Heart containers (see below for exceptions). All Red HeartRed Heart pickups are replaced with PennyPennies ( Half Red HeartHalf Red Heart = Penny, Red Heart (and (in Afterbirth † and Repentance) Blended HeartBlended Heart) = Double PennyDouble Penny, Double HeartDouble Heart = NickelNickel) ((in Afterbirth † and Repentance) though Blended Hearts can still spawn). HP up items (e.g.: Collectible Breakfast iconBreakfast) give Red Heart containers, but do not fill HP. Collectible Placenta iconPlacenta no longer has a chance to regenerate a Half Red HeartHalf Red Heart every minute. The VI - The LoversVI - The Lovers card spawns Pennies instead of Red Hearts. The 2 of Hearts2 of Hearts card and Collectible Yum Heart iconYum Heart, as well as (in Repentance)Collectible Yuck Heart iconYuck Heart, create no effect. The TickTick will still reduce a boss's health, but will not heal upon entering the Boss RoomBoss Room. ShopShops sell coins instead of hearts. Slot MachineSlot Machines, Blood Donation MachineBlood Donation Machines, the Hematemesis pill, and any of the BeggarBeggars drop coins instead of hearts. Even a Super Secret RoomSuper Secret Room which usually contains hearts will contain money instead. It is also impossible to recover health with Collectible Pyromaniac iconPyromaniac or Collectible Leech iconLeech. (in Repentance) This challenge is slightly easier in Repentance, as Charm of the Vampire now gives a small damage up.

Strategy[ | ]

The biggest difficulty lies in acquiring health. However, with numerous Red Heart containers, there are several strategies to survive the challenge. First is finding a way to heal Red Heart damage.

  • The Full Health pill is a major boon for this challenge.
    • The Bad Trip pill can also heal fully, but only when at one heart or less.
    • When combined with these pills, the Collectible Placebo iconPlacebo becomes very powerful. It can be purchased in Shops.
  • XIX - The SunXIX - The Sun card also heals to full health, alongside other benefits.
    • Combined with a Collectible Blank Card iconBlank Card, the challenge becomes trivial. This can be purchased from Shops.
    • (in Repentance)Collectible Sol iconSol's XIX - The SunXIX - The Sun effect works, granting full health after defeating each floor's boss.
  • Obtaining the Collectible Habit iconHabit or Collectible Sharp Plug iconSharp Plug from a shop allows Placebo or Blank Card to be used at will without any fear of death (though this may not be the case in Repentance due to these items being revamped).
  • Rainbow PoopRainbow Poop will also give full health, but it is also very rare.
    • (in Afterbirth † and Repentance)Collectible Bozo iconBozo has a chance to create Rainbow Poop when Isaac takes damage, thus picking it up can make the challenge substantially easier.
  • Beds still refill Isaac's health.
  • (in Afterbirth † and Repentance)Collectible Adrenaline iconAdrenaline is very helpful, as Isaac will have multiple empty Red Heart containers.
  • Blowing up a ShopkeeperShopkeeper counts as killing an enemy.
  • Should you happen to get a summon-based boss like Boss The Duke of Flies ingameThe Duke of Flies early, you can use the minions it summons to farm life, potentially giving you the equivalent of a full health pill on an early floor.

Second is getting rid of excess Red Heart containers. Removing even one Red Heart container will make obtaining deals with the Devil and Angel RoomAngel Rooms much easier, as the open HP spot can hold Soul HeartSoul Hearts/ Black HeartBlack Hearts, providing insurance against Red Heart damage.

  • The Devil RoomDevil Room or Black MarketBlack Market deals not only give good items, but also free up space for Soul Hearts. This, naturally, comes with the downside of preventing Angel Rooms from appearing.
    • Collectible Abaddon iconAbaddon can remove all Red Heart containers to be replaced by (except in Repentance) six Black HeartBlack Hearts ((in Repentance) twelve) , assuming no heart containers have been lost prior.
  • The Health Down pill can clear away some extra Red Heart containers to allow picking up Soul/Black Hearts. This can synergize with Collectible Placebo iconPlacebo nicely.
  • Collectible Guppy's Paw iconGuppy's Paw is one of the more useful items for survival because it removes hard-to-fill Red Heart containers and replaces them with Soul Hearts.
  • (in Afterbirth † and Repentance)Collectible Potato Peeler iconPotato Peeler can be found in shops and easily removes excess empty Red Heart containers for Collectible Cube of Meat iconCube of Meats, allowing you to easily get a couple of Meat Boys if desired.

A third method involves grinding enemies to replenish Isaac's health.

  • MulliganMulligans and their variants, SackSacks, and other spawning enemies can provide limitless sources of enemies to fill health.
  • Getting the Collectible D7 iconD7 and repeatedly clearing a room filled with easy-to-kill enemies can fill Isaac's entire HP bar.
  • The Shell Game can be a useful method of spawning Attack FlyAttack Flies.

Because hearts turn into coins, Shop purchases are easier to make.

Some other things to note:

  • If Isaac is at full health, the boss should take priority. Health lost during the battle can be replenished from unexplored rooms.
  • Avoid using Hematemesis, as it will drain you to one filled Red Heart container without spawning two to four hearts as usual.
  • If Isaac dies with a Collectible 1up! icon1up!, all Red Heart containers will be filled.
  • (except in Repentance) Collectible Judas' Shadow iconJudas' Shadow purges all Red Heart containers and leaves 2 Black Hearts. Additionally, Collectible Ankh iconAnkh will turn you into Character ??? (Character) icon???, who has no use for red health anyways.
    • (in Repentance) Judas' Shadow and Ankh can no longer spawn in challenges.
  • (in Repentance) Missing PosterMissing Poster will revive you as Character The Lost iconThe Lost, who has an innate Holy Mantle and does not care about health.
  • (except in Repentance) Mom's LocketMom's Locket refills half a heart each time a key is used.
  • Acquiring an Eternal HeartEternal Heart will allow Isaac to take an extra hit. However, no health will be granted when acquiring a second Eternal Heart or moving to the next floor.
  • (in Repentance) The bleeding mechanic from (in Afterbirth † and Repentance)Collectible Shard of Glass iconShard of Glass can be tricky to remove, as red heart healing can be rare. Consider skipping this item if you're having trouble healing.
  • (in Repentance)Queen of HeartsQueen of Hearts spawns double pennies instead of hearts.
  • Isaac's ForkIsaac's Fork works normally.


Reward[ | ]

  • 2 new pills
    2 new pills - Complete Have a Heart (challenge #25).
    • The pills unlocked are Re-Lax and ???.


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