Similarly, bendopnea has been previously associated with functional class NYHA III and IV, indicating it is a symptom of advanced HF.5,7 However, physical examination is essential in the diagnosis and treatment of HF and can provide as much insight into cardiac filling pressures as brain natriuretic peptides.4 NT-proBNP levels were higher in the bendopnea group on admission. Here, NPPB is linked to hydrops fetalis.