Pulmonary Sequestration Mimicking Symptoms of Ischemic Heart Disease

Pulmonary sequestration is a rare congenital abnormality characterized by the presence of a nonfunctional lobe of the lung being separated in both blood flow and function from the rest of the lung. The condition may go unrecognized on prenatal imaging and present during adolescence and young adulthood with cough, chest pain, shortness of breath, and recurrent pneumonia. However, some patients may remain asymptomatic until later adulthood and be diagnosed based on incidental imaging findings. Surgical resection is the recommended treatment for this condition, although controversy exists regarding its use in asymptomatic patients and adults. In this case report, we present a case of a 66-year-old man who presented with progressively worsening dyspnea on exertion and atypical chest pain and underwent an ischemic workup to rule out coronary artery disease. The extensive diagnostic evaluation led to the diagnosis of nonobstructive coronary artery disease and left-sided pulmonary sequestration. The patient subsequently underwent surgical resection of the left lower pulmonary lobe, resulting in a significant improvement in symptoms.