NPPB and hydrops fetalis: However, as analyzed, reviewed, and categorized by Bozkurt et al. (2021), combinations of three fundamental factors unite the various HF presentations: biophysical evidence of cellular and architectural pathophysiology (e.g., elevated brain-natriuretic peptide, fibrosis) (Gjesdal et al., 2011), patient-reported symptomology (e.g., fatigue, shortness of breath, decreased exercise tolerance etc.), and physician-observed signs (e.g., leg swelling, pulmonary edema).