A case of angiography-proven multiple coarctations of the pulmonary arteries is presented. The patient had a history of long-standing exertional dyspnea and intranasal cocaine use. A chest radiograph suggested oligemia in the left lung and enlargement of the right pulmonary artery, prompting ventilation and perfusion radionuclide lung imaging. The combined scintigraphic and radiographic findings were indistinguishable from those caused by pulmonary emboli. Although rare, this entity should be included in the differential diagnosis of multiple unmatched perfusion defects on pulmonary ventilation- perfusion studies.
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