In a large skillet, heat olive oil in skillet and add garlic and sausage. Cook on medium heat for about 3 minutes.
Meanwhile, bring water to a boil in large pot. Once boiling, add penne and cook until al dente.
Add bell peppers and onion to sausage and garlic, cook on low-medium heat until vegetables are tender, about 10-15 minutes.
Once pasta is cooked, drain and return to pot. Add heart healthy pasta sauce and Italian seasoning. Once vegetables are tender, transfer sausage and vegetable mixture to the pot with pasta and combine.
Portion out onto plate, and top with shredded Parmesan cheese if desired.