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When 6-year-old Ben Pastva was at a neighborhood pool in Fairfax, Virginia, a coach noticed his breaststroke.

"He's a natural," the coach told Ben's mother. The coach invited Ben to compete on the local team.

By age 11, he'd been swimming year-round for several years when he began specializing in freestyle. He became known as a sprinter, meaning that he excelled in races of 50 to 100 yards. Those distances demand intense energy for short bursts of activity.

By high school, Ben was considered his team's top sprinter. That's also when he began struggling with his health.

In his freshman year, Ben was out for several weeks with what doctors thought was pneumonia. From then on, his swim meet times slowed slightly.

Although he still felt strong, Ben started to wonder if he could compete at a top level. Ultimately, both he and his coach figured he was just tired and needed to work harder.

By his senior year, Ben had committed to swimming for Randolph-Macon College in Ashland, Virginia. He enrolled in the fall of 2020 at the height of the COVID-19 pandemic. There were no swim meets, but the team still practiced. When Ben wasn't swimming, he ran and lifted weights.

Yet instead of getting fitter, he started feeling weaker. He lost weight and became out of breath quickly. Even so, the summer after his freshman year, back home in Fairfax, he swam with two teams and took a lifeguarding job.

As the summer progressed, Ben felt so bad that he quit one team. He didn't tell his family or friends how awful he felt, but he was starting to lose confidence in his abilities. He was even losing his motivation to swim.

In August 2021, Ben came down with what he thought was a bad cold. Then he developed stomach pain and nausea. Following a quick trip to Florida with his mother to visit family, Ben was so sick to his stomach that he couldn't keep food down. Soon after, his mother, Kelly Weaver, was supposed to drop him off at college for his junior year. Instead, she told him: "No way are you going back to school like this. We're going to urgent care."

Normally, Ben would have put up a fight. This time, he was relieved to see a doctor.

Ben's very low heart rate led to him being hospitalized. Soon, he had excruciating chest pain. Then he went into cardiac arrest.

The care team resuscitated him. They knew he now needed a higher level of care, so he was transported to VCU Medical Center in Richmond.

Doctors there diagnosed him with dilated nonischemic cardiomyopathy – a weakened and enlarged heart that wasn't properly contracting. Nonischemic means his heart problems weren't caused by heart attacks or coronary artery disease but were likely from other causes.

Ben's heart was so weak that it had put stress on his kidneys, liver and various muscles. Explaining the organ damage, doctors told Ben: "If the heart dies, everything else dies."

Doctors placed him on extracorporeal membrane oxygenation, or ECMO, a last-resort treatment that uses a machine to take over heart and lung function when a patient's organs don't work on their own.

"I had so many tubes in me, it was freaky," Ben said. "But it kept me alive. I kept thinking, 'I just gotta get outta here. I just need to live.'"

Doctors said Ben needed a heart transplant. Ben and his parents understood it might be the only answer.

To Ben, this was hopeful but scary news. "I was trying to stay focused on my swimming career and was kind of relieved to find a solution to my problem."

To Kelly, it was mind-numbing. "I could hardly process it. One day I was taking an elite athlete to college, and the next day he needs a heart transplant?"

The severity of Ben's condition put him near the top of the national heart transplant waiting list. Less than two weeks later, he had a match.

On Sept. 11, 2021, Ben received a new heart.

Doctors said he'd likely be recovering in the hospital for two to three weeks. Being a 19-year-old athlete, he bounced back more quickly, going home within nine days.

"Although everything hurt, I was walking right away," Ben said.

Walking wasn't all he wanted to do. He was also eager to swim again. He pushed himself to get moving because "VCU (hospital) doesn't have a pool."

Two months later, Ben was back to swimming laps.

"I could do everything better than ever," he said.

Ben returned to college in January 2022. Since then, he's had a few medical setbacks but is now stable. He will need to take medication forever, but physically he has no limitations.

This year, especially, brought him many gifts.

From the time he started at Randolph-Macon, Ben had wanted to break the school record in the 50-meter freestyle. That mark was exactly 21 seconds.

In February, Ben swam the 50-meter freestyle in 20.99 seconds.

"When I got to the wall, I heard my whole entire team cheering really loudly for me," he said.

Ben knew that his heart donor was a 36-year-old son, husband and father. In August, he and Kelly met the donor's family.

"I got super stressed out about it because it's hard to face people who have endured so much suffering," he said. "But I'm also so grateful. Not everyone gets another chance. Now it's my responsibility to not take my life for granted."

Ben is now a college senior. He hopes to become an accountant, like his mother. Whatever path his life takes, he believes his medical journey has changed his approach to life.

"I feel nicer, more humble, and I care about people more," he said. "It feels a lot better."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.