Patient presents with findings suggestive of left anterior fascicular block (LAFB).  Electrocardiogram (ECG, EKG) demonstrates characteristic left axis deviation, with QRS duration within normal limits.  Specifically, the QRS axis is between -30 and -90 degrees.  Small q waves are noted in leads I and aVL, with small r waves in leads II, III, and aVF.  No significant ST segment or T wave changes indicative of ischemia or infarction are observed.  The patient denies chest pain, shortness of breath, palpitations, or syncope.  Review of systems is otherwise unremarkable.  Past medical history includes hypertension, well controlled with medication.  Family history is significant for coronary artery disease.  Current medications include lisinopril.  Physical examination reveals a regular heart rate and rhythm, with normal heart sounds and no murmurs.  Blood pressure and respiratory rate are within normal limits.  The patient's presentation is consistent with an isolated left anterior fascicular block.  Given the absence of symptoms and other concerning findings, this is likely a benign finding.  No specific treatment for the left anterior fascicular block is indicated at this time.  The patient will be educated on the nature of this conduction abnormality and advised to follow up regularly for routine cardiovascular care.  Differential diagnosis includes other conduction abnormalities such as right bundle branch block, left bundle branch block, and nonspecific intraventricular conduction delay.  ICD-10 code I45.1, Left anterior fascicular block, is assigned.  Continued monitoring is recommended.