The starting quarterback for the Patriots could have been one of those athletes who was felled by a hidden heart condition. But early detection helped him. Why can't it help everybody?

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There’s an indescribable smell that haunts Sam Brown.

The Liberty quarterback could be doing something mundane — washing his hands in a cabin on a camping trip last summer — and the scent will waft by, instantly taking Brown back to Aug. 22, 2016. The date of his open heart surgery.

“It’s a smell that was in the hospital room,” the junior said. “An awful smell.”

Brown, a 6-foot-2, 190-pound junior, is one of the lucky ones. His physician heard a faint heart murmur during a standard exam and referred him to a cardiologist for further testing. An anomaly in his right artery where the blood flow was constricted was found.

At any point of exertion, the defect could’ve triggered a fatal outcome of sudden cardiac arrest (SCA). Brown was given a choice: give up sports and live with the heart problem or miss one football season and have surgery.

SCA is the leading cause of death among young athletes. Raising awareness about heart screenings and prevention has become part of Brown family’s life.

“It was scary,” Brown said. “I’m only now starting to move on from it. Last year, it was tough to talk about, because it’s thinking about how I couldn’t play the sport that I love.”

Now, Brown and his father Rodney joke that the surgery gave Sam a super heart. After gaining nearly 30 pounds from being dormant while his body healed post surgery as a freshman, Brown lost the fat and gained muscle to transform into the quarterback Liberty coach Steve Valach said he anticipated.

Brown secured the starting quarterback position for the Patriots in Week 4 last year, leading Liberty to the Class 2A state tournament quarterfinals.

The Patriots are 5-1 this season and are fourth in The Seattle Times state football rankings. Brown is 53 of 79 passing for 924 yards with 12 touchdowns and two interceptions. Liberty hosts No. 3 Bellevue (6-0) in an expected KingCo 2A/3A classic on Friday night.

“It feels like he’s on another level this year,” Rodney Brown said of his son. “Going through that experience helped him grow. He just had to get through that and come out the other end a better person.”

“I’m only now starting to move on from it. Last year, it was tough to talk about because it’s thinking about how I couldn’t play the sport that I love,” Liberty quarterback Sam Brown said about the surgery that saved his life. (Dean Rutz / The Seattle Times)

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‘It’s so simple’

Fitness is the illusion.

Allen Harris. Matthew Truax. Nick Varrenti.

The trio of 16-year-olds from the Seattle area who died of sudden cardiac arrest have a story so similar to those across the nation. Seemingly healthy, fun-loving athletes who had played their sport only to collapse in what looks like a seizure but is actually SCA.

Harris died during a Federal Way football practice in July. Traux was running during a Meadowdale physical education class when he suffered his in 2013. Varrenti, who played football and wrestled for Jackson, died at home after a workout in 2004.

Varrenti’s death prompted his mother Darla to establish the Nick of Time Foundation in 2006. The nonprofit is a three-pronged effort to create awareness about SCA, provide tools to assist in emergency situations and help detect hidden heart illness in youths through screenings with an electrocardiogram analyzed by a cardiologist and sports physician.

Based in Mill Creek, the foundation has partnered with the University of Washington to screen 22,000 kids through 67 high schools in the state. Five hundred needed follow-up testing after an abnormality was found.

Cost for the 35-minute screening, which includes training in CPR and operating an automated external defibrillator (AED) machine, is a $25 donation.

“This is getting old,” said Dee Harris, Allen’s mother. “My son had perfect clearance to participate in the sport, even after knee surgery. If that ECG testing can save lives, then it needs to be mandated. Any parent would pay $25 bucks for their kid to have this test.”

Varrenti’s foundation was a force behind two bills passed by Washington state lawmakers.

The first bill, enacted in 2013, requires school districts to provide CPR and AED instruction as part of their health curriculum. The second bill, written into law in 2015, is the Sudden Cardiac Awareness Act which requires all youth athletes — whether at private or public schools or club sport programs — to review literature regarding SCA and sign a certificate of verification co-signed by a parent or guardian. The legislation also mandates all coaches complete an online SCA prevention program every three years.

Varrenti is still advocating for a proactive approach by having Washington state or the Washington Interscholastic Activities Association mandate youth heart screenings. Only tests that measure the heart’s electrical activity are beneficial in finding heart problems because murmurs, another indicator, aren’t always heard by primary-care doctors.

Texas proposed a bill in 2015 that would have made it the first state to mandate ECG screenings for public high-school athletes. It was approved by the Texas House but stalled in the state Senate. Italy, Israel, Japan, Taiwan and Canada require young competitive athletes to have an ECG before being cleared for play. A 2006 Italian study said there was an 89 percent decrease in SCA deaths since national screening began in 1982.

Dr. Wayne Hwang, a cardiologist at Virginia Mason and president-elect of the American Heart Association’s Puget Sound board, said the U.S. national debate regarding screenings revolves around cost effectiveness and specificity of the tests because the deaths are rare.

“But that’s my ultimate goal. I would love to see every kid’s heart screened,” said Varrenti, noting the biggest problem is the lack of doctors trained to read a youth’s ECG correctly.

“And I don’t have any sympathy for medical professionals who don’t understand that making sure our kids are as safe as possible to do the things they love is a priority,” Varrenti continued. “Incorporating a simple ECG into their sports physical can make all the difference in the world. … It’s so simple.”

Sam Brown, left, dragged his girlfriend Megan Catalani to a heart screening which revealed she needed surgery. (Courtesy of Kris Brown)

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‘They’re little angels’

After Sam’s surgery, a neighbor emailed his mother, Kris Brown, a link to Nick Of Time’s website. She immediately signed up as a volunteer and helped Liberty High, which is in Renton but is part of the Issaquah School District, host a screening in April.

Sam was active in publicizing the event, yet when he looked around the gym packed with classmates getting tested and practicing CPR on dummies, someone was missing — his girlfriend.

Megan Catalani, who had recently completed her tennis season, had a science test she didn’t want to miss. Brown dragged her out of class to go through the screening.

Catalani, who plays for the junior varsity volleyball team, was the last student tested and an abnormality in her heart was found. She was one of three Liberty students advised to get more testing.

“It’s crazy, because I had to convince her to go,” Brown said. “She was scared.”

Further testing found Catalani had patent ductus arteriosus, an opening between the two major blood vessels leading from the heart, according to the Mayo Clinic website. She underwent a cardiac catheterization procedure in August that ended up being minor because the opening was minute. Doctors went in through an artery in her leg, Catalani left that evening and was only in bed for a week.

“The Browns, they’re little angels,” said Megan’s mother Terri Catalani. “Being a nurse, we were totally caught off-guard. We’re a healthy family that never had an issue and this (floored us), having a cardiologist tell you that your daughter has something irregular with her heart. … She was not in the catastrophic category, but we have the technology, why don’t we do it for everybody?”

In addition to supporting the screenings, Megan and her family are participating in the Puget Sound Heart and Stroke Walk on Oct. 13 at Seattle Center. Dubbed the “Catalani Crew,” Megan raised $450 alone in donations for the American Heart Association.

Liberty quarterback Sam Brown, working with coach Steve Valach, has been a starter since his sophomore season. (Dean Rutz / The Seattle Times)

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Back under center

Brown wasn’t cleared to return to football until February 2017, and his father made him wait an extra month to do anything chest related to allow more time to heal.

Still, Sam woke his father up every day at 5 a.m. to either work out in their basement or head to the gym. Rodney laughs, remembering how much his son hated being limited to the treadmill as he slowly worked his way back to on-field training.

When the football season began, Brown was on the junior-varsity squad.

“He was a big question mark when he came in — finally,” said Liberty offensive coordinator Cameron Talley, who spends his lunchtime breaking down film with Brown. “We missed him his freshman year and didn’t have any tape or evidence of how good he was. After the first (JV) game it was immediate, ‘No, he’s a varsity football player.’ Then he worked for the starting spot and hasn’t looked back since.”

Brown has a strong arm and quickness. This season he’s working on being a vocal leader in hopes of getting the Patriots back to the playoffs.

“I tear up thinking about it, I’m just so thankful my son’s was found,” Kris said. “After that, he said, ‘I’m going to play varsity.’ And he worked his tail off to get back out there and play. It’s what he loves. He’s such a great example of somebody who really wants something go get it.”