Introduction: Partial anomalous pulmonary venous connection is the type of cyanotic disease defined as one or more, but not all pulmonary veins drain directly either into a systemic vein or into the right atrium. Subarachnoid block in the form of spinal anesthesia is given as it minimizes SVR changes, and provides sufficient anesthesia of perineum/pelvic organs, sensory and motor blockade of lower limbs, allowing early ambulation, voiding, and hospital discharge.

Case Report: A 29-year-old female, G2P1L1, BMI of 25 with 32 weeks 5 days gestational age with 8 months of amenorrhea posted for emergency lower segment cesarean section (LSCS). Preanaesthetic evaluation was done and the patient underwent LSCS under spinal anesthesia without any intraoperative difficulty or complications.

On POD-9, the patient developed breathlessness with a fall in oxygen saturation and required Intensive care unit (ICU) support. A 64-slice CT pulmonary angiogram was done and showed changes suggestive of Partial Anomalous Pulmonary Vein Connection (PAPVC).

The patient was worked up, diagnosed with PAPVC, and symptomatic treatment initiated. Once symptomatically better, prophylactic management is advised and the patient is discharged.

Conclusion: Patients with PAPVC with stable hemodynamics can be managed successfully with spinal anesthesia as the mode of anesthesia for surgical procedures.