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- use sacrifice room and cursed room,
- active item that give dmg for life are good,
- keep in mind that after 6 times hit you wont get buff any further for the current floor,
- as your buff provide additive dmg, items that give multiplicative dmg buff synerrgise well
- as you'll be interested in intentionnally getting hit to get buff, any item that will boost any heart drop/refill or your regen is VERY good with blood lust
- as you take dmg you wont get much access to devil/angel room, you can get good runs without it, as blood lust is strong.
But definitely take the Curse Rooms as often as possible. You might find something worth taking the hits for AND also build up some damage for the rest of the floor.
good exemple of great combo with samson
Child´s heart trinket and Little Chad as well for getting more heart drops.