ACE and hydrops fetalis: OMT is considered as the using of all the “four pillars” suggested by HF guidelines (i.e. beta-blockers, angiotensin converting enzyme inhibitor or angiotensin receptors blockers or angiotensin receptor/neprilysin inhibitor, mineralocorticoid receptor antagonist and gliflozin) and, when appropriate, the implant of a cardiac resynchronization therapy device [6].