In the UK, the HF patient care pathway generally begins with a referral from primary care to a hospital for suspected HF based on clinical symptoms, ECG findings and elevated levels of N-terminal pro-brain natriuretic peptide (NTproBNP).10, 12 If the diagnosis is confirmed, hospital treatment stabilises patients and discharges them back into the community with a treatment plan including GDMT.2 This evidence concerns the gene NPPB and hydrops fetalis.