elastosis is also associated with aortic stenosis. Calcified aortic stenosis, important in adults, is hardly ever seen in children. Congenital aortic stenosis may also be associated with non-cardiac abnormalities in certain genetic syndromes; for example, Marfan's syndrome and von Recklinghausen's disease*. Supravalvar stenosis has recently been reported as part of a stenosis in which there is also mental retardation and a characteristic facial appearance (Beuren, Apitz, and Harmjanz, I962). Aortic stenosis has been found associated with idiopathic hypercalcaemia in children. Black and Bonham Carter (I963) have presented several examples of aortic stenosis associated with the facies of severe infantile hypercalcaemia. The incidence of congenital heart disease among all live births probably approaches i % (Richards, Merritt, Samuels, and Langmann, i955), and the incidence of aortic stenosis among all cases of congenital heart disease is about 3 % (Wood, I956; Keith et al., I958); therefore approximately I in 3,000 tO I in 4,000 live births have aortic stenosis.

A late preterm infant with intrauterine growth restriction developed respiratory distress, tachypnoea and hypoxia after birth, requiring supplemental oxygen. Chest radiographs demonstrated persistent elevation of the right hemidiaphragm. Chest ultrasound initially demonstrated symmetrical bilateral diaphragm motion, but subsequent ultrasounds showed asymmetrical excursion with weaker movement of the right hemidiaphragm. Placental pathology demonstrated chronic infectious villitis secondary to cytomegalovirus (CMV), and subsequent CMV testing on the infant was positive. The infant was microcephalic and head imaging revealed intracranial calcifications, consistent with congenital CMV infection.CMV is the most common congenital infection and has a wide array of clinical manifestations. This report highlights the rarely described association between congenital CMV infection and respiratory distress due to underlying diaphragm dysfunction. In neonates with respiratory distress and features of congenital CMV infection, clinicians should have a high index of suspicion for diaphragm dysfunction.