Documentation appeared to impact cardiac testing (evaluation of left ventricular function), use of beta blockers, and choice of glucose-lowering medications, with lower use metformin and SGLT2 inhibitors (paradoxically, given their benefit in patients with HF [5, 17–19], prescription patterns that have been previously noted [1]) and thiazolidinediones in patients in whom HF was documented. Here, SLC5A2 is linked to hydrops fetalis.