title: Acromegaly, the systolic click syndrome, and group D streptococcal endocarditis.
abstract: A syndrome consisting of an apical systolic click and late systolic murmur appeared over a period of three months in a patient with acromegaly. Levels of growth hormone were highest during this interval. As a result of group D streptococcal endocarditis three months later, the patient sustained cerebral embolism and acquired free mitral regurgitation from ruptured chordae tendineae. During follow-up over 18 months, neither the level of growth hormone nor the degree of mitral regurgitation changed significantly.
mesh_terms: D000172:Acromegaly / Q000150:complications*; D004697:Endocarditis, Bacterial / Q000150:complications*; D013293:Enterococcus faecalis; D006326:Heart Auscultation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology*; D013290:Streptococcal Infections; D013577:Syndrome