Scimitar syndrome most commonly presents with one anomalous pulmonary vein draining into the IVC. This case is an unusual variant in which the patient has two anomalous veins that drain into the IVC: one classic scimitar vein and another smaller vessel. Heart size was normal and there was no evidence of chamber dilatation.

Despite having an extra vessel, the patient was asymptomatic and denied having any history of chronic shortness of breath or fatigue. This is likely because the volume of blood being drained from the two vessels is still not significant enough to cause a severe left-to-right shunt. Her presentation to the ED was due to pneumonia, and her diagnosis of scimitar syndrome was incidental. Her condition improved with antibiotics, and she was discharged the next day.