NR3C2 and hydrops fetalis: In patients with HF with reduced ejection fraction (HFrEF), guideline-directed medical therapy is anchored by a foundational quadruple regimen; renin-angiotensin system inhibitor/angiotensin receptor-Neprilysin inhibitor, sodium–glucose cotransporter 2 inhibitor, and mineralocorticoid receptor antagonist (MRA) [1,3,4].