It still seems like the hearts take a significant penalty on you if you aren't doing anything when they explode. What's up with that?
Hearts clearly seem to scale the further along you are in a run, certain monster hearts feeling absolutely egregious by loop 2 and the game as a whole being nigh impossible by four.
Sustain or big bonk is a necessity for every build because of it, and outside of some fine-tuning I sadly don't think there's much to be said about damage taken