Item: Sacred Heart
+0.3 tears up. Allows Isaac to fire tears diagonally.
Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.
Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.
Spawns a familiar that follows Isaac around and collects red hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one soul heart, one hostile Spider or one friendly blue spider.
Displays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.
Eye of Belial
Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.
Bucket of Lard
Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.
+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.
When Isaac receives damage, the bottle breaks and a puddle of blue creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.
An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Spawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.
Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Drops a random trinket. Grants a second trinket slot.
Gives a random chance for projectiles to fire in all 4 cardinal directions.
Sack of Pennies
Isaac is followed by a small bag that drops a coin every 2 rooms.
Increases damage by 1, range by 5.25, and tear height by 0.5.
Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.