The human heart is a complex bundle of arteries, veins and chambers, a forever contracting and expanding organ that blasts blood throughout the body.
In some rare cases, a heart’s muscles can enlarge and thicken because of a genetic condition called hypertrophic cardiomyopathy. The disease is the No.1 cause of sudden cardiac death in young athletes, and it has no cure.
Star Lotulelei, by all accounts, does not have hypertrophic cardiomyopathy.
But when a standard medical screening at the NFL Combine in February showed that Lotulelei might have one of the condition’s key symptoms, it damaged his once-lofty draft prospects nonetheless.
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Lotulelei, once a candidate to be the top pick in next week’s draft, is now a wild card. He could go to the Eagles with the fourth overall pick, or he could fall to the low teens.
That uncertainty could open the door for Dolphins general manager Jeff Ireland, who covets defensive tackles, to select Lotulelei — so long as he’s confident about the Tongan giant’s health.
The good news: Based on all the information made public over the past month, Lotulelei’s abnormal test in Indianapolis was a fluke.
“I wouldn’t have any concerns about [drafting him],” said Dr. Clifton Page, a sports medicine internist with the University of Miami Health System.
“It’s probably teams being overly cautious,” Page said of Lotulelei’s drop. “I understand they’re investing a lot of money in these players. Is it fair to the player? Probably not. But I understand from a business perspective.”
Lotulelei’s saga began in February, when a combine echocardiogram revealed he had an abnormally low ejection fraction. The left ventricle of his heart was only pumping at 44 percent efficient, ESPN reported at the time, dangerously below the normal range. That’s a sign the patient could have some sort of heart failure, potentially hypertrophic cardiomyopathy.
But Lotulelei has since undergone — and passed — a battery of new tests, participated in Utah’s pro day and was medically cleared by the Eagles, the team’s general manager said recently.
Doctors believe the irregularity was transient, likely the result of a viral infection. The technical term for the condition is myocarditis, and it is potentially fatal as well. But it also is treatable, and it’s possible that the combine screening saved his life, Page said.
Lotulelei’s camp says he has since recovered. However, his draft stock has not, making it difficult to guess how far he will slide next Thursday. If far enough, he could be the steal of the draft.
NFL.com describes Lotulelei as a “powerful and agile starting nose tackle prospect. Versatile enough to play almost all interior defensive line positions across many types of fronts.”
Scouts credit his burst off the ball and his superior pad control. NFL Network’s Daniel Jeremiah, a former pro scout, ranks him fourth among all draft-eligible players.
“He’s not Haloti Ngata,” Jeremiah said, referring to the Ravens defensive tackle who is bigger and stronger than Lotulelei. “This guy is kind of a poor man’s version of [Ndamukong] Suh.”
Still, there are a few concerns that go beyond his health. Some doubt his drive and his long-term ability to manage his weight, which was once near 350 pounds.
Yet the tape doesn’t lie. He was dominant during his last two years at Utah, recording 6.5 sacks and 19 tackles for loss — a remarkable showing for someone who made a living via manual labor just a few years prior.
Officially known as Starlite Lotulelei, he was born in Tonga on Dec. 20, 1989. Lotulelei moved with his family to Utah when he was in grade school.
A promising high school prospect, Lotulelei couldn’t make the grades needed to attend BYU, so he delivered furniture for a while before catching on at Utah.
He has been, for lack of a better term, a star there. Lotulelei would have been a first-round pick if he had come out last year, but decided instead to get his sociology degree and stay close to his family. He has a wife, Fuiva, and two daughters, Arilani and Pesatina.
Instead of attending next week’s NFL Draft, which 23 other prospects plan to do, he will watch his name get called at home with them.
Exactly when in the night that name will be called, however, will depend on team’s faith that his health is not a risk.
If the virus has indeed been beaten, the best medicine at this point is rest.
“Most people would say three months, and then return to normal activities,” said cardiologist Robert J. Myerburg, a professor of medicine and physiology at the UM Miller School of Medicine.