The pharmacotherapy of HF primarily relies on a combination of medications that address different aspects of the condition, often referred to as the “four pillars” for HFrEF: angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor-neprilysin inhibitors (ARNIs), beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 (SGLT2) inhibitors. This evidence concerns the gene SLC5A2 and hydrops fetalis.