This delayed activation also results in a widening of the QRS complex, although not to the extent of a complete LBBB. Diagnosis
Abnormal left axis deviation (usually between –45° and –60°)
qR pattern (small q, tall R) in the lateral limb leads I and aVL
rS pattern (small r, deep S) in the inferior leads II, III, and aVF
Delayed intrinsicoid deflection in lead aVL (> 0.045 s)LAFB cannot be diagnosed when a prior inferior wall myocardial infarction (IMI) is evident on the ECG. IMI can also cause extreme left-axis deviation, but will manifest with Q-waves in the inferior leads II, III, and aVF. By contrast, QRS complexes in the inferior leads should begin with r-waves in LAFB. Effects of LAFB on Diagnosing Infarctions and Left Ventricular Hypertrophy
LAHB may be a cause of poor R wave progression across the precordium causing a pseudoinfarction pattern mimicking an anteroseptal infarction. It also makes the electrocardiographic diagnosis of LVH more complicated, because both may cause a large R wave in lead aVL. Therefore, to call LVH on an EKG in the setting of an LAHB you should see the presence of a “strain pattern” when you are relying on limb lead criteria to diagnose LVH

Clinical significance
It can be seen in approximately 4% of cases of acute myocardial infarctionIt is the most common type of intraventricular conduction defect seen in acute anterior myocardial infarction, and the left anterior descending artery is usually the culprit vessel. It can be seen with acute inferior wall myocardial infarction.
Diagnosis
Diagnosis for pigment dispersion syndrome is made with characteristic slit lamp and gonioscopy findings. Management
There is no cure, but pigmentary glaucoma can be managed with eye drops or treated with simple surgeries. If caught early and monitored, chances of glaucoma are greatly reduced. A 2016 Cochrane Review sought to determine the effectiveness of YAG laser iridotomy versus no laser iridotomy for pigment dispersion syndrome and pigmentary glaucoma, in 195 participants, across five studies. No clear benefits in preventing loss of visual field were found for eyes treated with peripheral laser iridotomy. There was weak evidence suggesting that laser iridotomy could be more effective in lowering intraocular pressure in eyes versus no treatment. References


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