TTR and hydrops fetalis: It is worth noting that the pathophysiological and hemodynamic profile of ATTR-CM, as well as the frequent involvement of the autonomic nervous system [6,7], could make the initiation and up titration of the conventional HF medication, such as beta-blockers, renin–angiotensin–aldosterone system (RAAS) inhibitors, and mineralocorticoid receptor antagonists, particularly challenging.