Hypercoagulation

Item Icon
Pickup Quote	"Thick blooded"
Entity ID	5.100.724
Item Pool	Treasure Room Ultra Secret Room Treasure Room
Quality	2
Item Tags
Collection Grid	(page 6, column 9, row 6)
Unlock Method	Defeat Delirium as Tainted Magdalene

Hypercoagulation is an unlockable passive item added in The Binding of Isaac: Repentance.

Effects

• After Isaac takes damage from an enemy or donates health, he drops a Red Heart that despawns after 1.5 seconds.
  • The heart dropped depends on the source: half-hearts of damage taken drop Half Red Hearts, and full hearts of damage taken drop full hearts.
  • The hearts will get launched out of Isaac with momentum, making them difficult to pick up.
  • If Isaac is firing tears as he gets hit, the heart will get launched in that direction.

Notes

• Damage sources that scale up from half a heart of damage to a full heart of damage starting on Womb/Corpse will still only cause Hypercoagulation to spawn half a heart. However, being hit by a champion enemy will still spawn a full red heart, even though all enemies do a full heart of damage by that stage.
• Red hearts are not spawned when Isaac loses heart containers (such as through health down pills, buying Devil Room items, using Guppy's Paw, etc), with the only exception being Potato Peeler.
• Red hearts will still drop regardless of the type of heart being subtracted from damage, making the item generally useless for characters who cannot utilize red hearts.
• The following damage sources will activate Hypercoagulation:
  • Enemy attacks
  • Normal spikes
  • Spiked rocks
  • Fire Places
  • Explosions
  • Blood Donation Machines
  • Devil Beggars
  • Confessionals
  • Hell Games
  • Razor Blade
  • Blood Rights
  • Dull Razor (despite it not taking health)
  • Potato Peeler
  • Extra damage taken from holding Glass Cannon
• The following damage sources will not activate Hypercoagulation:
  • Curse Room doors
  • The door to Mausoleum
  • Sacrifice Room spikes
  • Spiked Chests/ Mimic Chests
  • Bad Trip pills
  • Golden Battery
  • Kamikaze!
  • Breath of Life
  • A Pound of Flesh shop spikes
  • IV Bag
  • Sharp Plug
  • Shard of Glass
  • Blood Bombs
  • Blood Oath

Synergies

• Blood Rights / Razor Blade: Damage taken to use the item also spawns hearts, reducing the cost of using them. The first usage of these items each room will spawn a full red heart.
• Cancer / Percs! pill / The Wafer: Damage sources that spawn full red hearts will still spawn a full red heart despite the cost being reduced to half a heart.
• Candy Heart / Immaculate Conception: The hearts will count toward gaining stat boosts/familiars.
• Dull Razor: Can be used to spawn full red hearts for Isaac to pick up. Ideally, this should be done in a confined space so Isaac can easily pick up the heart.
• Equality!: As long as Equality is active, all hearts spawned will be doubled and never disappear. Hearts remain on the ground even after the effect is no longer active.
• Maggy's Bow: Doubles the healing received from the hearts spawned.
• Magneto / Super Magnet: Will immediately start pulling the dropped hearts to Isaac, breaking their momentum and making collection much easier.
• Cambion Conception: By intentionally taking damage with something like a fire and grabbing the half-red hearts, Isaac can easily generate powerful familiars for free.

Interactions

• Ace Cards / Diplopia / D1 / Rune of Jera: Converted/duplicated hearts will not disappear.
• Compost: The temporary heart will be converted into a Blue Fly/Spider.
• D20 / GB Bug: Rerolled hearts will still disappear.
• Glass Cannon: Spawns two more full red hearts when Glass Cannon breaks, regardless of how much health was lost to it.
• Keeper / Tainted Keeper: Spawns blue flies upon getting hit, essentially granting them the same effect as Infestation.
• IX - The Hermit?: The heart will not be converted to coins.
• IV Bag: Doesn't spawn hearts.
• Daemon's Tail: Hearts spawned do not turn into keys but simply do not spawn 80% of the time, and the 20% that do spawn will always be Black Hearts.

Trivia

• Hypercoagulation (otherwise known as Thrombophilia) is a medical condition that causes blood clots to spontaneously form in a person’s blood vessels and prevents them from dissolving properly.

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