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I got a whole slew a different heartcolors, red is the normal hearts, white is the same as in the original (keep it and you get an extra heart on the next floor, or when you pick up a second one), blue hearts are also the same as in the original game. But this time around, there are also black/dark grey hearts. I got one of these as a drop, picked it up and now I have a black heart. Note that this is an extra heart, so it's not a damaged red heart.

All kinds of hearts

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They're called Sin Hearts, and they damage all enemies in the room when depleted. Much like the Necronomicon spacebar item.

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  • Do they also randomly cause some necronomicon effect when not damaged either? Or was that some other item?
    – Arperum
    Commented Nov 4, 2014 at 20:43
  • @Arperum That would be one of the trinket items called (I think) The Missing Page.
    – Powerlord
    Commented Nov 5, 2014 at 14:24
  • @Arperum If you're getting Necronomicon effect without taking damage, it's probably the dry baby familiar. He absorbs bullets and can sometimes activate Necronomicon effect.
    – Crubleigh
    Commented Jan 27, 2015 at 0:28

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