That description reminds me of STACKER:
http://db.tigsource.com/games/s-t-a-c-k-e-rIt got next to no attention, but I thought it was a touch of genius. You play a STALKER from the game STALKER (not typing all those periods). The tetris game is you maintaining your inventory, and its contents determine the outcome of your encounters with enemies, rabid dogs, radiation, and mental decay.
If you have a whole AK-47 in your inventory, it's a weapon you can use. Ditto with armor. If a dog shows up in your inventory, you get "bitten" every so often. You can also encounter artifacts (which affect your sanity) and bandits who toss grenades into the mix, which can explode and abuse your HP and damage inventory.
Clearing lines can get rid of junk and deadly stuff, but also damage your inventory. Death and mental disturbance cause your vision to flicker and warp.
It's not the most fun game in the world, especially if you go into it just expecting Tetris, but it is just slightly brilliant. It's also a slightly funny commentary on classic RPG inventory juggling.