Indeed, present pediatric HF algorithms, adapted from adult guidelines, now include four pharmacologic pillars: angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers/angiotensin receptor–neprilysin inhibitors (ARNIs), β-blockers, mineralocorticoid receptor antagonists, and sodium–glucose cotransporter-2 (SGLT2) inhibitors. This evidence concerns the gene NR3C2 and hydrops fetalis.