Upon removing a certain number of Black Hearts, the Angel will reward the player with an item from the angel room pool, alongside additional rewards depending on how many times the player has been rewarded.

Upon entering, the Angel will fully refill the player's Red Hearts and remove all of the player's Black Hearts.

All Angel Rooms are replaced with a unique layout featuring an Angel statue with a broken wing that offers no items normally.

If Black Hearts are the only type of heart the player has, taking damage in combat immediately kills the player no matter how many Black Hearts they have.

This includes challenge rooms, as they start cleared.

Taking Black Heart damage outside of combat damages the player normally.

If a spirit hits the player twice in the same room, it dies and will not go back to the player at the end of the room.

After combat is finished, the spirits will disappear and black hearts will be restored with no damage.

These spirits will move to one of the cardinal sides of the player, charge for a moment, and dash across the room, dealing contact damage to the player and enemies.

Each Black Heart will spawn one spirit.

Upon taking Black Heart damage while in combat, all of the player's Black Hearts will be removed and reform as spirits.

When returning to rooms with uncollected Black Hearts, any Black Hearts in the room will immediately transform into spirits and fly off-screen.

Soul Hearts already collected or spawned before obtaining Penance are unaffected.All spawned Soul Hearts pickups are replaced with Black Hearts, as well as Soul Hearts gained through other means (such as Book of Revelations).Unlocked Penance - Defeat Mom as Sarah.

The binding of isaac unblocked