By Adam Rittenberg (ESPN.com)/March 17, 2008

For most college football players, the final step before medical clearance involves testing a reconstructed knee on a cutback route or lowering a repaired shoulder into a blocking sled.

Terence Campbell's final hurdle was Plavix, a common blood thinner used to prevent dangerous clots from forming. As long as Campbell took Plavix, he couldn't play football for East Carolina.

"Once I got the news I was able to come off the medicine," Campbell said, "it was the best thing I ever heard."

Barely a year after suffering a heart attack and undergoing an emergency procedure, Campbell, a once-promising offensive tackle for the Pirates, has returned to the field for spring practice. Cleared to play in February, Campbell participated in East Carolina's first two workouts before reaching a more meaningful milestone: his 21st birthday.

Playing football was the goal, but Campbell always maintained a healthy dose of perspective. This wasn't an athlete rushing back, putting his sport ahead of his life. Campbell exhausted every avenue to make sure he was making a wise choice.

"I was going pretty much everywhere," Campbell said. "No doctor is going to give you a '100 percent, you're OK to go, it's not going to happen again,' but the best thing is get word from different doctors and see what they think. Everybody thinks I'm at low risk."

Campbell appeared to be at no risk before Feb. 27, 2007. He had zero history of heart problems and had started all 13 games in the 2006 season, earning Conference USA All-Freshman Team honors.

But on the last day of winter workouts, two days before spring practice was set to open, Campbell felt chest pains.

"[The trainers] told me, 'Go home. If your arm starts to feel numb or something, give us a call,'" Campbell said. "It worsened, so I called them. It kind of just came out of nowhere. We didn't know exactly what was going on. Then the doctors were saying I had a heart attack."

That night, the 19-year-old Campbell underwent a non-surgical procedure to clear blockage and remained hospitalized for several days.

He started monitoring his diet, cutting back on McDonald's and Gatorade in favor of salads and water. He shed 15 pounds. He mentored young offensive linemen during practice.

During those early months, playing football again wasn't on the table.

"The main thing was let's just make sure Terence can live a healthy life, monitoring his cholesterol, his blood pressure, his weight, changing his eating habits," East Carolina coach Skip Holtz said. "I said, 'Once we get to the point where we feel good about the health, then we can look at the possibility of playing again.'"

Campbell lost count of all the doctor's appointments he attended, the tests he endured and the opinions he received.

"You name it, I was going through it," Campbell said. "The doctors knew I'd be fine and be able to live a healthy life, but they also knew that I wanted to also play football. They took that into account with making their decisions. It was very helpful."

After getting the go-ahead in January from a cardiologist in Charlotte, Campbell sensed a return to football was near. Since he had no prior heart problems, he was allowed to come off Plavix and started taking baby aspirin as a blood thinner.

He still takes Lipitor to control his cholesterol and several other medications, but nothing that keeps him off the field.

"There aren't many people who have gone what he's been through and played college football," Holtz said. "I don't think there's been anybody. His patience, how hard he's worked to get himself back in shape, the way he's pushing himself and the smile on his face, it's been really neat to see.

"This is what he wants to do. It's his decision, not ours."

Despite the layoff, the 6-foot-5, 320-pound Campbell is quickly catching on in spring ball. East Carolina must replace starting tackle Josh Coffman, and Campbell is gunning for his old job.

"I don't complain anymore about having to practice," Campbell said. "Now I look forward to it."

Adam Rittenberg covers college football for ESPN.com.