ACE and hydrops fetalis: According to the 2016 guidelines for the diagnosis and treatment of acute and chronic HF of the European Society of Cardiology (ESC), optimal pharmacological HF therapy consists of symptom management with diuretics, nitrates and/or digoxin, as well as the improvement of prognosis with angiotensin converting enzyme inhibitors (ACE I), angiotensin receptor blockers (ARB), mineralocorticoid receptor antagonists (MRA), and beta-blockers (BB)8.