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EpiphanyCardiac Arrest"Sheer heart attack"Active item (5 seconds recharge time)
While heldGrants a bleed bar that is shown under the normal health bar on the HUD.

When the bleed bar is at a negative amount, it will gradually drain, increasing the counter by 1 until it reaches 0. Each full drain of the bar damages Isaac for half a heart, prioritizing red hearts.

If Isaac does not have enough hearts when the bar runs out, it will instead take a full heart container which increases the counter by 4. The counter cannot go over 0.

The bleed effect can kill Isaac if he does not have enough health or heart containers.

Bleeding also applies the effects of Anemic, granting +1.5 range and causing Isaac to leave a trail of red creep that deals 2 damage per tick (20 per second).

One drain of the bar takes ~11 seconds. The drain speed increases based on the bleed counter.

On useDamages Isaac for half a heart, sets the bleed bar at -2 and fires off a big piercing and spectral tear.

The tear deals 4x Isaac's damage. The direction of fire can be controlled by the fire keys - the item is not used until manually fired.

A temporary damage boost is granted for each enemy hit: +0.73 for the first enemy, +0.29 to +0.21 for the next 4 enemies (each enemy lowers it), and +0.09 and less for subsequent enemies.

The damage boost decays over the course of 9 seconds.

6 temporary Half Red Hearts are dropped for the first enemy hit, and 2 less for every subsequent enemy hit, but no less than 1.

The hearts dissapear after 2 seconds, or 2.33 if a boss was hit.

Golden variant Shoots 2 additional delayed projectiles in the direction Isaac is aiming at that deal 2x Isaac's damage.
Unlock: Earn all completion marks as Tarnished Magdalene.
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