Heartbreak

Effects

Grants +0.25 damage for every broken heart Isaac has.
Immediately grants 3 broken hearts. Every otherwise fatal hit will instead add 2 more, replacing other types of hearts if necessary, and deal 40 damage to all enemies in the room.
- Once Isaac has no non-broken hearts left, he dies. Extra lives will apply at this point.

(Found Soul) Found Soul: The ghost gains 2 extra hits per floor and every hit they take will damage all enemies in a room as well.
(Keeper) Keeper: Keeper will lose all coin hearts and gain 3 broken hearts, resulting in immediate death without extra lives.
(The Lost) The Lost: The Lost has full benefit of the item. This lets him survive 4 extra hits, each hit adding 1 damage, and the 5th is fatal.
Guppy's Collar: Guppy's collar has a chance to respawn Isaac with an extra half soul heart on death, even if Isaac has already reached 12 broken hearts. Taking any health up items will kill Isaac again.
Plan C : Upon use no broken hearts are gained and Isaac dies.