<prompt> Answer this question truthfullyWhat is the natural course, possible complications, and expected outcome associated with anomalous pulmonary venous connection?  <response>: <reason> There are few symptoms in infancy or childhood. After many years of excess pulmonary venous return, right atrial and right ventricular RV dilation may occur as a result of volume overload in the adult. RV dilation and enlargement is in turn associated with arrhythmias, cor pulmonale or right-sided heart failure, and, in some patients, the development of pulmonary hypertension. 