ACE and hydrops fetalis: Current European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines [1,2] indicate starting therapy with angiotensin converting enzyme inhibitors/angiotensin receptor neprilysin inhibitors (ACEi/ARNI), beta blockers (BB), mineralocorticoid receptor antagonists (MRAs) and sodium glucose cotransporter 2 inhibitors (SGLT2i) to reduce the risk of death and hospitalization due to HF, in patients with HF with reduced ejection fraction (HFrEF).