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UPDATE: Tuesday, April 2, at 2:37 p.m. ET
As expected by many, Lotulelei's heart scare seems to be a thing of the past. Pro Football Talk's Darin Gantt reports Lotulelei's heart function is back to normal. Specifically, there is "no evidence of dysfunction."
Put Lotulelei back to the position he occupied on big boards before the February echocardgiogram. His medical risk is now likely insignificant.
--End of update--
The stars were aligned for University of Utah defensive tackle Star Lotulelei to be taken with one of the first few picks of the 2013 NFL draft.
Then, doubts began to swirl.
In February, ESPN's Chris Mortensen reported that Combine physicians discovered Lotulelei's left ventricular ejection fraction (LVEF) to be 44 percent. In other words, Lotulelei's heart was pumping out only 44 percent of the blood within it with each beat. A normal LVEF is 55 to 70 percent.
Even though he was experiencing no symptoms, concerns that his heart might not be able to meet his body's demands during intense exercise—something that could lead to anything from mere light-headedness to a life-threatening irregular heartbeat—led to Lotulelei being held from working out at the Combine. Instead, he returned to Utah to undergo further testing.
Causes of a low LVEF range from the minor and temporary to serious and chronic. As of March 27, no reports detailing the exact cause of Lotulelei's low LVEF yet exist, possibly owing to the fact that no cause is identified up to 50 percent of the time.
Of course, exact medical details are unavailable to the public, but at this point, it is probably safe to say the cause of Lotulelei's low LVEF is a reversible one. Additionally, the probability that he suffers from a chronic or progressive heart condition is essentially zero.
How can anyone be so sure of that from the outside looking in?
Simple. When it comes to the heart, the balance of risk versus reward is too dramatically skewed toward risk to allow for any uncertainty. No doctor would clear Lotulelei to work out at Utah's pro day with a dangerously under-performing left ventricle.
With that in mind, the fact that Lotulelei did work out at Utah's pro day after being cleared by cardiologist Josef Stehlik is extremely reassuring (h/t Doug Farrar, Yahoo! Sports). It strongly suggests the condition is both temporary and resolving. In fact, there is a decent chance the low LVEF may have gone entirely unnoticed if it didn't happen to be caught by an echocardiogram.
Nevertheless, teams will be curious. Medical reports should help clear the air, but questions will remain. Is his LVEF back in the 55-to-70 range? Will this happen again? When it comes to possibly investing in a top-10 draft pick, teams can never be too sure.
Risk Level: Moderate
Potential Upside: High to very high
I took a more detailed look at what could be going on with Star Lotulelei's heart back on Feb. 25.