Health

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Health Stat Icon.png Health represents the amount of damage the player can take before dying. There are four different types of health in the game, each with their own pickups. The health bar is the visual representation of a player's health on the HUD.

  • The order in which hearts are placed is, from left to right, Red Hearts (and empty Red Heart containers), Eternal Hearts, then Soul Hearts or Black Hearts (depending on the order in which they were picked up).
  • Hearts are generally lost from right to left: Last grabbed Black/Soul Hearts, Eternal Hearts, then Red Hearts.
    • The exception to this rule is self-damaging items like 15►Razor Blade Razor Blade, Devil Beggars and Blood Donation Machines, which always prioritize Red Heart containers. From these sources, health is lost in the following order: Eternal Hearts, Red Hearts, then Soul/Black Hearts.
  • The character can only hold a maximum of twelve hearts, and any permutation of the four different types can be used. Picking up a Black or Soul Heart will refill a halved Black/Soul Heart (the other half is then placed at its right); Soul Hearts can replenish Black Hearts and vice versa.
  • The damage taken by Isaac depends on the item, hazard or enemy and the specific attack used by the enemy, but in chapters 1 to 3 most sources deal half a heart of damage unless otherwise specified. Chapter 4 onwards all half-heart hits deal a full heart of damage.

Red Heart Containers[edit | edit source]

Full red heartHalf red heartEmpty red heart

Red Heart containers, or Red Hearts, are the main form of health for the majority of characters. If the player has only Red Hearts, the containers will be unfilled as damage is taken (but the containers themselves remain). Empty Red Heart containers can be refilled with Red Heart pickups. If Isaac takes a heart that would heal him for more than his current maximum health (for example, taking a Red Heart when he is only missing half a Red Heart worth of health), the excessive health will be wasted. The number of Red Heart containers can be increased with multiple items or Health Up pills or decreased with items, Health Down pills, having another player join a game as a baby, or trading them away in a Devil Room or at an underground Black Market.

Soul Hearts[edit | edit source]

Full soul heartHalf soul heart

Soul Hearts are blue hearts that are appended to the end of the health bar. Unlike Red Hearts, Soul Hearts do not have containers, so once they're depleted, new ones must replace them. If Isaac has Red Hearts and half a Soul Heart, taking a full heart of damage will not remove any Red Hearts. Losing Soul Hearts does not count as damage for Devil Room or Angel Room appearance chances, but does count as damage taken for the Basement Boy, Spelunker Boy, Dark Boy, Mama's Boy, and Dead Boy achievements.

Black Hearts[edit | edit source]

Full black heartHalf black heart

Black Hearts are similar to Soul Hearts in that they are appended to the end of the health bar, are not permanent, and that losing them does not count as damage for Devil or Angel Room chances. However, when a Black Heart is depleted, 15►The Necronomicon The Necronomicon effect is triggered, damaging all enemies in the current room. Picking up a Soul Heart while at half a Black Heart will complete the Black Heart and add half a Soul Heart, and vice versa. If Isaac is at his HP cap and any of his hearts are Soul Hearts, the Black Heart will replace the rightmost Soul Heart when picked up.

Eternal Hearts[edit | edit source]

Empty red heart

Eternal Hearts are the rarest variation of a heart. They always appear as half-hearts and, once picked up, can transform into a new Red Heart container in two ways: either by collecting a second Eternal Heart at the same level or by traveling to the next floor. Eternal Hearts are not permanent, cannot be refilled when lost and do not count for the limit of twelve hearts, instead of overlapping the rightmost Red Heart container. If no Red Heart containers are available, the Eternal Heart will overlap the leftmost Soul Heart or Black Heart. If Isaac has 12 Red Heart containers and travels to a new floor with an Eternal Heart, Isaac will heal one Red Heart but will not gain another Heart Container. If Isaac is at full health, the Eternal Heart will simply disappear.

An Eternal Heart will be used up the first time Isaac takes Red Heart damage (but is not lost by taking Red Heart damage if Isaac has no Red Heart containers). Health removal from Devil Room deals will not drain an Eternal Heart; rather, the Eternal Heart is appended onto the end of the next Red Heart. An Eternal Heart cannot keep Isaac alive on its own; making a deal with the Devil which drains all hearts except the Eternal Heart will kill Isaac. Removed in Repentance This also means that using a Blood Donation Machine or activated items like the 15►Razor Blade Razor Blade will drain the Eternal Heart, even if Isaac has full health and Soul Hearts.

Added in Afterbirth † Since Bone Hearts are treated as Red Hearts, Eternal Hearts will be appended to the rightmost Bone Heart even if there are Soul and Black Hearts between it and any Red Hearts.

Added in Repentance Blood Donation Machines and other items and devices that take red hearts directly will ignore Eternal Hearts, even if Isaac has no other red hearts left.

Added in RepentanceEternal hearts now have a special animation of giving a soul heart to ???.

Gold Hearts Added in Afterbirth[edit | edit source]

Empty red heart

Gold Hearts are unlocked by completing the XXXXXXXXL challenge. Once picked up, the Gold Heart surrounds Isaac's rightmost heart. The Gold Heart does not prevent damage, but when the heart that the Gold Heart surrounds is depleted, several Pennies will spawn and enemies will be changed to gold statues, similar to 15►Midas' Touch Midas' Touch effect. Gold Hearts can be 'pushed off-screen' if you have twelve hearts, at least one being a Soul, Black, or Bone Heart, and pick up a health up. Pennies will still appear if this happens. Losing many hearts at once — for example, by picking up a Dead Cat or using a Hematemesis pill — will correspondingly trigger the Gold Heart effect many times at once and shower you with coins.

Coin Hearts Added in Afterbirth[edit | edit source]

Full coin heartEmpty coin heart

Coin Hearts are a special heart type used exclusively by Keeper Added in Repentanceand Tainted Keeper. Coin Hearts always take a full heart of damage from all sources, even with 15►The Wafer The Wafer. They can only be replenished by acquiring money (either through picking up coins or obtaining items such as 15►A Quarter A Quarter), which will consume one cent from the coin pickup for each heart restored. They are always treated as Red Hearts and can be sold in Devil deals or Black Markets. See Keeper#Notes for more information.

Bone Hearts Added in Afterbirth †[edit | edit source]

Full bone heartHalf bone heartEmpty bone heart

Bone Hearts are special Red Heart containers unlocked alongside The Forgotten, and are appended to the end of the health bar. Empty containers can be filled with Red Hearts and filled containers take three hits to deplete (or two hits against sources that deal a full heart of damage), but disappear permanently upon depleting. Bone Hearts, empty or full, are considered Red Hearts by most items Removed in Repentance but cannot be used for Devil deals or Black Markets. Bone Hearts will be emptied when picking up items that remove all Red Hearts, such as 15►Abaddon Abaddon and 15►Brittle Bones Brittle Bones. Losing Bone Hearts or the Red Hearts contained within will not affect the chance to find a Devil Room or Angel Room, with the exception of The Forgotten who receives a penalty for a Bone Heart breaking. Acquiring an empty Red Heart container while you have a filled Bone Heart will fill the new heart and empty the Bone Heart. Blue Baby can pick up Bone Hearts, but cannot fill them with Red Hearts.

Added in Repentance Bone Hearts can be filled with Rotten Hearts. They can also be used for Devil deals or Black Markets, unless the character can't have red heart containers.

Rotten Hearts Added in Repentance[edit | edit source]

Rotten heart2.png

Rotten Hearts are special Red Hearts unlocked by entering the Corpse for the first time. They can be used to fill empty Red Heart containers, or will replace the rightmost Red Heart if there are no empty Red Heart containers. Rotten Hearts always take a full heart of damage from all sources, even with 15►The Wafer The Wafer. Losing Rotten Hearts will not affect the chance to find a Devil Room or Angel Room. After clearing a room, two friendly Blue Flies are summoned for each Rotten Heart Isaac currently possesses.

Broken Hearts Added in Repentance[edit | edit source]

Broken Heart.png

Broken Hearts are special Red Heart containers that only appear when using 15►Magic Skin Magic Skin, 15►Heartbreak Heartbreak, or a reversed The Lovers card. Broken Hearts are considered empty Red Heart containers but cannot be removed or refilled under normal circumstances. They cannot be used for any Devil Deals, they cannot be refilled with any form of Heart, or replaced by any Heart Container. They are permanently applied to the character for the rest of the run, even after using items that can revive or change the current character. The only way to remove them is to donate to a Confessional Machine which has a chance to remove them with each donation. Replacing all 12 Heart Container slots with Broken Hearts will cause Isaac to instantly die, and reviving after this causes Isaac to have a fake Heart Container that will disappear upon obtaining any new item or taking any form of damage.

Unlockable Achievements[edit | edit source]

Trivia[edit | edit source]

  • Upon entering a room with only half a heart left, a small yellow spot, presumably urine, will appear underneath Isaac.
    • If Isaac has Added in Afterbirth15►Kidney Stone Kidney Stone, a bloodstain will appear instead of urine.
    • Added in Afterbirth † As Eve, a red bloodstain will appear instead of urine.
Isaac leaving a urine puddle at low health.

Bugs[edit | edit source]

Bug Bug! Gold Hearts will be consumed if a self-damaging item is used to remove a Red Heart while the Gold Heart is surrounding a Soul/Black Heart.


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