Mineralocorticoid receptor antagonists (MRAs), most commonly spironolactone, are a class of drugs shown in randomized clinical trials to markedly reduce mortality, hospitalization, and sudden death in patients with HF and reduced ejection fraction.4, 5, 6 Prior studies, however, found that adoption of MRAs7, 8, 9 was poor in outpatients with HF and in HF patients after hospitalization. Here, NR3C2 is linked to hydrops fetalis.