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Cook the penne pasta according to the package instructions. Drain and set aside.
Heat 1.5 tablespoons butter in a large skillet over medium-high heat. Season the chicken breasts on both sides with Cajun seasoning, Italian seasoning, and a little salt and pepper, if desired.
Add chicken to the skillet and cook for 5–6 minutes on each side, or until golden brown and cooked through. Remove from the pan, rest briefly, then slice into strips.
In the same skillet, melt the remaining butter. Add sliced sausage and cook for 2–3 minutes until browned. Add mushrooms and cook for another 3–4 minutes until softened.
Stir in the minced garlic and cook for about 30 seconds until fragrant.
Pour in chicken broth and Worcestershire sauce, stirring to loosen any flavorful bits from the pan.
Reduce the heat to low. Add heavy cream, Cajun seasoning, paprika, and garlic powder. Heat until the sauce starts to thicken (about 3–5 minutes).
Stir in the Parmesan cheese until melted and the sauce is silky. Taste and adjust salt or Cajun seasoning as desired.
Add cooked pasta, chicken, and sausage to the skillet. Toss everything together until coated and heated through.
Serve hot, garnished with extra Parmesan and a sprinkle of Cajun seasoning if you like.