Light-Hearted Approach

Her answers were punctuated with laughter. Not the nervous kind, but genuine.

Cassie Azevedo, 22, giggled after admitting she was taking the same medicine as her 80-year-old grandmother and joked about wearing an oxygen tank while playing water polo in case she loses consciousness again and nobody notices.

As Long Beach State’s top player and its soon-to-be career scoring leader, Azevedo, a senior, has learned to take a light-hearted approach to life. In her case, it makes a big difference.

For nearly 10 years, she has suffered fainting spells related to vasovagal syncope, a condition whose symptoms include the sudden loss of consciousness, which occurs mostly during strenuous physical activity, after an injury or during times of emotional stress.

Despite this, she will lead the 49ers into the Mountain Pacific Sports Federation tournament April 27-30 at UC Irvine. Long Beach, which had a combined conference record of 22-11 during her first three seasons, is only 4-8 this season (15-12 overall), but that’s partly because Azevedo sat out four games -- the first time her condition has affected her playing time.

“It was so hard,” she said. “You feel like you’re letting your team down.”

She watched her young teammates lose three straight games and drop from a tie for first to 11th place in the 13-team conference.

To qualify for the NCAA championships, May 12-14 at UC Davis, the 49ers probably will need to reach the conference tournament semifinals. A tall order, considering the strength of USC, UCLA and Stanford, but Azevedo says she believes fourth place is up for grabs.

“I don’t want to say that we could never beat them,” she said, “but they’re just really good teams and we’re really new.”

Azevedo also is hopeful of playing overseas this summer, though she’s not sure where -- as long as it’s away.

With a last name that has become synonymous with U.S. water polo -- her father, Ricardo, spent seven seasons as the 49ers’ women’s coach before becoming coach of the U.S. men’s national team last year, and her older brother, Tony, is emerging as one of the best players in the world -- Azevedo is looking forward to making a name for herself.

“I’ve always been a Long Beach girl,” she said. “I kind of want to step out for a while and play somewhere else without my father, without my mom, without my boyfriend, without everybody around knowing who I am.”

She has 204 career goals at Long Beach State, leaving her three shy of surpassing Angelica Garcia as the school’s all-time scoring leader. Azevedo says the only reason she’s aware of the record is because her teammates keep reminding her.

“Right now, that’s just not a priority, whatsoever,” she said. “I don’t even like to think about it because then it puts you out of your game.”

Azevedo already has experienced more than her share of distractions this season.

In addition to a full load of classes -- she hopes to graduate next month -- there’s her health.

Vasovagal syncope causes fainting when an inappropriate reflex of the vagus nerve triggers an irregular heart rate and lowers blood pressure, causing blood to begin pooling in the lower extremities because not enough can be pumped to the brain.

Azevedo keeps her condition in check with medicine, but a pacemaker also would do the trick.

“I’m so young, [the doctors] don’t want to put a pacemaker in,” she said.

Azevedo fainted for the first time during a volleyball workout in seventh grade, but she wasn’t diagnosed with vasovagal syncope until last summer, and midway through this season, her symptoms grew worse.

“It just started to happen a lot more,” she said.

Before a game at San Jose State on March 4, Azevedo went to the team trainer because her heart was racing. The trainer advised Coach Ken Lindgren that there was “a 50% chance” that she would be OK by game time.

“I said, ‘No, I need a 100% chance or she’s not playing,’ ” said Lindgren, a member of the U.S. Water Polo Hall of Fame. “I don’t care if she’s playing for the championship of the universe, her health is too important.”

Azevedo took the news hard. With their best player sidelined, the 49ers lost to San Jose State, 9-5. The next day, they were hammered by Stanford, 14-5. Azevedo said that was the low point of the season.

“Our team is so much better than that,” she said. “It was just infuriating to see that game.”

Since her return, the 49ers have gone 6-5. Azevedo continues to work herself back into shape and, at the same time, tries not to overexert herself.

Lindgren says he often keeps one eye on Azevedo and another on her teammates.

“It bothers her mentally more than physically,” he said. “She starts pushing the workouts and she starts feeling weird, but she doesn’t know if it’s because she’s tired or maybe it’s the heart getting ready to act up again.”