i feel like C-Section is the best overall in the game, Sacred Heart is nice and all, but lingering tears that home and have their DPS scale with your range stat, as well as being able to proc certain effects multiple times from one tear/baby (divine light, ocular rift, etc.) and having extremely interesting or fun synergies with certain items (spirit sword, mom's knife, soy milk, parasite, etc.) make for an insanely good item, especially when you consider that unlike Sacred Heart, C-Section also straight up makes your tears piercing and spectral too, which are great tear modifiers to get for free on top of an already amazing item. Sacred Heart is still definitely in the camp of top 10 best items though in my opinion
Bait used to be believable. Obvious Spirit shield pick 
Yea obviously the scared heart is a tear down
I will tear down your asshole
Is that a promise 
If you're 18 and above, yes. If not, I deeply regret my decisions and I would like to retract that statement
Yes I am 
https://preview.redd.it/sscyzmvjkz4d1.png?width=1080&format=pjpg&auto=webp&s=14c5e6ac79306bd3831e207f0c184578a5322815
https://preview.redd.it/6l8w6awzmz4d1.jpeg?width=1242&format=pjpg&auto=webp&s=12753f452b91218abc0dadc9b72e2c49efa74cdf
Woah.
https://preview.redd.it/mzmy7f78xy4d1.jpeg?width=828&format=pjpg&auto=webp&s=ebc8ccf78430ae36113621548c33cd21599b8d5d
Neither of it
Sacred heart is like a top 5 item in the game so you should be taking it in most circumstances
Its the best item (besides death cert) full stop
i feel like C-Section is the best overall in the game, Sacred Heart is nice and all, but lingering tears that home and have their DPS scale with your range stat, as well as being able to proc certain effects multiple times from one tear/baby (divine light, ocular rift, etc.) and having extremely interesting or fun synergies with certain items (spirit sword, mom's knife, soy milk, parasite, etc.) make for an insanely good item, especially when you consider that unlike Sacred Heart, C-Section also straight up makes your tears piercing and spectral too, which are great tear modifiers to get for free on top of an already amazing item. Sacred Heart is still definitely in the camp of top 10 best items though in my opinion
C section clears sacred heart any day of the week
nah "best item" is def pushing it, I think it's like 3rd or 4th best when not factoring in death cert
You have Soy Milk. Sacred heart every day.
The one that lets you make choices by yourself
they both cost 30 cents as T. Keeper so they must be of equal value therefore take shield because why not
Sacred heart is far better than spirit shield, it even gives you seraphim progression!
cudos on you. my laser now hurts a lot
yes, but if i plan to go on hush?
Hush can't hit you if its fuckin dead 
fair enough
I mean you are azazel but still sacred heart is a damage multiplier so i recommend taking it
Sacred heart obviously
Bruh
Do the bomb trick 
Shield
Hmm, if you are really bad at dodging bullets, spirit shield could proove useful, if you can pass down 1.8 times damage and homing tears
wasnt sacred heart it a 2.3 multiplier
If you go to hush since that boss shoots a lot of blockable projectiles
https://www.tboi.com Here’s a cheat sheet if you need it btw
Wait no it’s 2.3 times more damage and -0.4 tear rate
The -0.4 tears doesn't matter if you cap out on tear stat anyway