The muscle-packed striker, from the hard-luck shadows of Freetown’s international airport, was on the rise.

And then in February, as Norrkoping was preparing for a campaign that would include its first appearance in Europe’s premier continental competition since 1963, medical test results arrived: Kamara was told he had a congenital heart defect.

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Norrkoping shut him down. UEFA, the governing body that administers such tests for participation in the Champions League, wouldn’t allow him to play.

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“Is this true,” Kamara recalled asking himself, “or am I dreaming?”

Less than three months later, the striker is back on the field, cleared by two U.S. cardiologists – one aligned with D.C. United, the other with MLS – who reviewed his case and tested him further.

Yes, they concluded, Kamara did have a deviation of the coronary artery, as the test results in Sweden had uncovered. Medical teams on either side of the Atlantic, however, had differing opinions of the severity of the condition and whether he could resume playing soccer.

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Norrkoping released an ominous statement in February, saying Kamara was at a “high risk of sudden cardiac death during maximum exertion.”

The American doctors disagreed.

“Under the condition he has, he’s fit to play,” Allen Taylor, United’s team cardiologist and chief of cardiology at Washington’s MedStar Heart and Vascular Institute, said in an interview.

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Matthew Martinez, MLS’s cardiology consultant, concurred. And with his approval, the league allowed United to acquire Kamara for Norrkoping last week at no initial cost. The Swedish club would collect a fee next year, at the earliest, if Kamara meets an undisclosed threshold of production and if, someday, United sells his playing rights for a profit. Contract terms were not disclosed.

“I was always positive,” said Kamara, who turned 22 last month. “If everyone else gives up, I will be the last person to believe.”

Kamara’s path to Washington began more than two months ago. United General Manager Dave Kasper had contacted Kamara’s agent, Patrick Mork, about someone else. Mork said that player was not available but Kasper might have interest in someone with a unique medical issue.

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When Kasper learned the details of Kamara’s case, “We were concerned, of course.”

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United officials requested images and reports from Mork and Norrkoping, then passed them to their chief medical officer, Daniel Hampton. As all players must be cleared by MLS, Hampton forwarded them to Martinez. They agreed that Kamara needed to undergo further examination and testing in the United States.

Kamara visited Taylor at MedStar Georgetown University Hospital. He underwent a stress test, which monitors heart rhythm, blood pressure and breathing.

“We also looked at the heart muscle in the most detailed way possible – a heart MRI to look for scarring or any sign of problem related to this,” Taylor said. “We found none. We looked for past signs and potential for problem and found none.

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“We’ve gone far beyond what is even the recommended evaluation. It’s all about wanting to be completely thorough.”

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Accompanied by United staff members, Kamara visited Martinez at his practice in Allentown, Pa., a 180-mile trip each way.

Martinez submitted his report to MLS, clearing Kamara to join the league.

“He’s been cleared by top cardiologists,” Kasper said, “so we have full confidence” in Kamara’s health and welfare.

“There are risks,” Mork told Sweden’s Sport Expressen newspaper, “but they are minimal.”

As part of the deal, Kamara must undergo heart testing annually.

The initial diagnosis, Kamara said, does not worry him as he resumes his career.

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“If I am afraid, I wouldn’t be out there training again,” he said. “They would never give me permission to play if there was any risk.”

So why did one group of medical experts rule him out and another allow him to play?

Taylor, who studied such artery conditions during a 20-year medical career with the U.S. Army, called it an “evolution in thinking.”

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He explained that, “over the last 10 years, there has been the advent of other ways to examine the arteries and the heart. And what that has led us to understand is that these things are rather common.”

Taylor went on to say people with deviant arteries run marathons and exert themselves without complication. “The risk seems very small,” he said.

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Heart conditions are a sensitive issue for United. Last year, forward Eddie Johnson, a U.S. national team player, was forced to retire because of the risk of cardiac arrest. His case, though, was different than Kamara’s. “Apples and oranges,” Taylor said.

Johnson suffered from hypertrophic cardiomyopathy, a disease that affects the muscle of the heart and has led to the death of several athletes.

Kamara’s move also comes at a fragile time in the soccer world. Recently, two 26-year-old players died of apparent heart attacks during matches in Romania and Brazil.

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Kamara said he knew of those tragedies but, given his medical clearance, did not give a second thought about returning to action.

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“You can wake up healthy and get into your car and something happens,” he said. “It doesn’t matter if, at the hotel where I am staying [in Washington], I look outside and somebody walks and a car smashes them. Do I say I won’t go outside again?”

Kamara said he has no family history of heart problems and, two years ago when Norrkoping loaned him to a club in Malaysia, he passed the same test that flagged his artery condition this winter.

When the issue first arose, he encouraged his agent to pursue opportunities elsewhere, fully aware he would have to undergo additional testing.

“There are different views” of his condition, he said. The thought of retiring is “something I didn’t accept.”

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Kamara grew up in Lungi, a coastal town north of the Sierra Leone capital of Freetown, with his parents and three siblings. His father Ibrahim drove a taxi, his mother worked for local businesses. “Not always did we have the resources to put food on the table,” Alhaji Kamara said.

Sierra Leone was scarred by civil war from 1991 to 2002, but Kamara said his family was safely far enough from the hot spots. He did, however, recall leaving Lungi for a year, when he was young, and settling in his mother’s village to avoid danger. The two-day trek was by foot.

Kamara played for a neighborhood team before joining Belvic United in Freetown when he was a teenager. Aside from his love of the game, he hungered for the fame that, for a fortunate few, followed success. Living near the airport, he remembered the commotion when Sierra Leone star Mohamed Kallon would fly home from playing with Inter Milan and Monaco.

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Kamara’s first contract, at age 18, was with FC Kallon, owned since 2002 by the famous player of the same name. In late 2011, Kamara had a tryout with MLS’s Portland Timbers but did not reach agreement. He played for three clubs in Sweden before settling with Norrkoping.

Now, after six months without a competitive match, Kamara is seeking to regain fitness and forge chemistry with new teammates. He and club officials said he’ll need several weeks to settle in and get up to speed.