In this condition, four pulmonary veins instead of draining into left atrium, drain abnormally into a common chamber behind the heart. From this chamber the blood drains to the right side of heart through vertical vein  Life persists due to communication between right and left atrium through a septal defect and thereby supplying blood to left sided chamber. The disease becomes more severe when veins draining blood from lungs or the vein draining the common channel have obstruction. These cases present very early in life.

Lethargy, poor feeding, rapid breathing, frequent respiratory tract infections, cyanosis (bluish  discoloration of skin).

Echocardiogram is the main stay of diagnosis.

Early surgical correction by connecting the common channel to the left atrium is the treatment of choice. The communication between the two atrial chambers is closed and the draining vein is ligated.