This is an interesting case of unilateral absence of a pulmonary artery (UAPA), a rare entity that can present with non-specific symptoms such as chest pain and shortness of breath, or be entirely asymptomatic 1.
In many cases, UAPA is associated with other congenital abnormalities such as aortic coarctation or tetralogy of Fallot 2.
In this case, several subtle findings on the chest x-ray hint at the diagnosis.