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ans should be familiar with these anatomic variants to enhance its recognition, understanding that a muscular variant is rarer than previously reported, but historically can serve as a potential source of clinical symptomatology and could be encountered during physical examination or wrist surgery. Heart failure (HF) is common in older people. The diagnosis of HF, however, is difficult in older subjects, especially in settings without direct access to further diagnostics. The type of blood pressure response during the performance of aVa