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Foul occult magic, rare alchemical reagents, and copious amounts of spilled blood are the keys to creating a vitalia—also known as a heart horror— though thankfully the exact means of their creation has been long forgotten.

Now, most vitalias now come into being by sheer accident. This unusual life-form cannot live without regular contact with blood, much like how fish cannot live long outside of water. Because of this, vitalias are rarely found outside the lairs of mad alchemists or wizards, living in pools of the life-giving substance. Physically, a vitalia somewhat resembles a blood-red giant jellyfish, though it also bears some semblance to a giant human heart.

Recall Knowledge - Aberration (Occultism): DC 43

VitaliaCreature 18

Source Pathfinder #155: Lord of the Black Sands pg. 84
Perception +30; bloodsense (precise) 30 feet, tremorsense (imprecise) 60 feet, no vision
Skills Athletics +33
Str +7, Dex +5, Con +9, Int -5, Wis +0, Cha +0
Bloodsense The vitalia can detect any creatures that have a heartbeat.
AC 39; Fort +35, Ref +25, Will +24
HP 425 (fast healing 20); Immunities bleed, mental, sleep, unconscious, visual; Weaknesses piercing 15
Blood Eruption ReactionReaction Trigger A creature lands a critical hit with a melee Strike against the vitalia Effect The vitalia sprays blood at the triggering creature. The creature must succeed at a DC 39 Reflex save or become dazzled for 1 round (or blinded for 1 round on a critical failure).
Speed 15 feet, swim 30 feet
Melee Single ActionSingle Action vein +33 [+28/+23] (magical, reach 15 feet), Damage 4d8+15 bludgeoning plus GrabRanged Single ActionSingle Action blood squirt +33 [+28/+23] (acid, magical, range increment 40 feet), Damage 3d10 bludgeoning plus 3d10 acidOccult Innate Spells DC 36; 8th vampiric exsanguination; 6th status (at will), vampiric touch
Constrict Single ActionSingle Action 4d8+10 bludgeoning, DC 37Forced Transfusion Single ActionSingle Action Requirements The vitalia is grabbing a creature; Effect The vitalia inserts some of its veins into the grabbed creature and pumps violently, rapidly exchanging the victim's blood with its own. Any diseases or poisons affecting the vitalia can be transmitted to the target creature, which must make a saving throw as though it had just been targeted with the original affliction. The inverse is true as well; the vitalia must successfully save against any diseases or poisons affecting the target or contract the affliction.Sanguine Rain Two ActionsTwo Actions (necromancy, occult) Frequency once per day; Effect The vitalia pumps copious amounts of blood into the air, creating a cascading rain of vital fluids in a 15-foot emanation. All creatures in the area are concealed from one another. A creature that benefits from consuming blood (such as bloodseekers or vampires) gains fast healing 10 while in the area. While in the area, a creature taking persistent bleed damage cannot end that condition, even if it spends actions to attempt a flat check to do so. The rain lasts for 1 minute.

Sidebar - Additional Lore Living Livers

A vitalia's ability to filter and purify even days-old blood makes them highly sought after by certain powerful individuals, especially frail leaders or moguls in pursuit of eternal youth, vampires, or other creatures with sanguinary predilections.