Courtesy photo             Nick Madrigale with his significant other Danielle Hayes and their four children.

By Richard L. Gaw

Staff Writer

If one’s complete assessment of an individual begins and ends with the content of a photograph, then the one taken of 31-year-old Atglen resident Nick Madrigale that accompanies this article tells the story of a man who has been given everything.

There he is, gathered with his long-time partner Danielle Hayes and their four children – two daughters and two sons -- on a trip to Disney World, and the glint in Madrigale’s eye can be indicative of another sunny day at the happiest place in America, or the supreme sense of peace and enjoyment he is feeling, knowing that those he loves the most are beside him…everything he has ever wanted from life.

Yet, there is one thing that Madrigale needs that is both invisible to the camera’s eye and yet absolutely vital to the sustainability of his life. It forms the continuing conversation he has had for many years with others and with himself that sounds often like a prayer and a whisper and a plea.

The smiling man in the photograph needs a new heart.

Madrigale was born with Hypertrophic Cardiomyopathy (HCM), a cardiovascular disease that is characterized by an abnormally thick heart muscle that limits the amount of blood to the heart and creates complications in getting oxygen-rich blood to the rest of the body.

As a result, those with HCM can experience a lack of energy, a fast heartbeat and severe chest pain. Often called “The Hidden Disease,” HCM affects one in every 500 people but only 200,000 people in the U.S. are properly diagnosed every year, meaning that as many as 85 percent of those with HCM remain unaware of their condition.

Thankfully, Madrigale was first diagnosed with HCM when he was five years old, following three incidents when his heart stopped and he required CPR and chest compressions to keep him alive. He was placed on several heart medications, and when he was eight years old, he was fitted for his first pacemaker/defibrillator, which was placed in his stomach because he was not old enough to have it in his chest.

His condition, however, required the young Madrigale to limit his outdoor play at home and at school, which meant no contact sports like hockey and football. Limited in what he could do, he found his love for writing and music.

‘Having to deal with it for so long, it became normal’

“I had to remain inside during school recess,” Madrigale recalled. “A lot of the time, my teachers would let me select a friend who would stay inside the classroom with me. No one wanted me to do much of anything because everything seemed like such a big risk.

“Having to deal with it for so long, however, it became normal, and luckily I had a lot of good friends around me who understood that and accepted me.”

After graduating from Downingtown West High School in 2009, Madrigale went into sales, first for a large department store, then in the claims department for an insurance firm, later at D’Ambrosio Chevrolet in Oxford and most recently at Ephrata Bank in Lancaster County. In May of 2021, he was diagnosed with pneumonia, and while in the emergency room, the medics attending to him measured his heart’s blood flow – or ejection fraction (EF). 

In a normal heart, an ejection fraction is measured between 50 and 70 percent, and any percentage under 40 is considered dangerous. Madrigale’s EF numbers were at 18 percent, and he was subsequently diagnosed with chronic heart failure and remained in the hospital for the next nine days.

Over the next year, despite being prescribed several medications, receiving a new cardiac catheter and going back to work at the bank, Madrigale’s heart failure had progressed. He spent an additional seven days in the hospital, where he was given a peripherally inserted central catheter (PICC) that rushed blood through a vein in his arm to his heart. When he returned home, he was given an IV for Milrinone and a pump.

Soon, Madrigale was referred from The Heart Group at Lancaster General Hospital to the Penn Heart Transplant Program in Philadelphia. Located at the University of Pennsylvania, the center is one of the top ten heart transplant programs in the nation and one of the five largest heart transplant centers in the mid-Atlantic region. Since its founding in 1987, Penn Heart has performed nearly 1,500 transplants, more than all other centers in the region combined.

In addition to the realities of needing a heart transplant, Madrigale is faced with the untold financial burdens of paying for his continued treatment. While his short-term disability pays 60 percent of his salary, it ends at the end of September, when he will be faced with paying 100 percent of his medical bills out-of-pocket, as well as co-pays and uncovered and unplanned costs associated with his treatment.

$17,000 from private and business contributions, so far

After the latest round of tests and evaluations, Madrigale was released from Penn Heart on Sept. 18 and while he recovers back at his home in Atglen, his physicians will be discussing his case over the next few weeks that will be followed by another evaluation by a committee to ultimately decide the timeline for the date of his heart transplant.

Currently, Madrigale is listed as a Status 4 heart transplant recipient, a level designated for a heart patient who is on a life preserving device. If he maintains his health, Madrigale cold receive his transplant sometime in the next six months to a year. In the event his health deteriorates, his status will be upgraded and the date of his transplant moved up.

To help defray his mounting medical costs, Madrigale recently collaborated with Danielle and Carolyn Hrynkow to establish a GoFundMe page that has to date attracted 119 donations that has raised more than $17,000 toward a $50,000 goal, which included a Beef & Beer benefit held a few weekends ago that raised $7,000 in private and business contributions. On Sept. 24, a Casino Night fundraiser will be held at a private home in Morton, Pa.

“Nick and Danielle are the most resilient young people I have ever seen,” said Karen Brown, Danielle’s aunt. “They love their kids. They take care of their kids, and they keep moving forward. Nick has become an inspiration for me. He never gives up hope. He never plays the victim but instead, he is an optimist, and he tackles hurdles as they come.

“That is what inspires all of us -- his family and his friends. None of us can imagine what they are going through, but he and Danielle try to keep their life with their children as normal as possible.

“It is family, it is community, it is friends,” Brown added. “When we think about our world, they are the most important people around us. There are no instantaneous answers, but they are who we need to go forward in this world.”

Several years ago, Madrigale recorded a song called “Better Way – Nick Nemesis,” that includes the words, “Gotta be a better way.” It’s become a family slogan for tough times.

“In the end, it doesn’t make you feel any better about the situation to say, ‘Poor me,’” Madrigale said. “We have four children, and I owe it to them to be able to provide them with everything I possibly can.

“This is a step right now, not an ending. Danielle and I are going to keep going. Life may be different right now, but as long as we keep focused on the end result, we’ll get through this. That’s how I have lived my life. That’s how I will continue to live my life.”

To learn more about Nick Madrigale and to make a contribution to help defray his medical costs, visit “The journey for a new heart for Nick Madrigale” on gofundme.com.

To contact Staff Writer Richard L. Gaw, email [email protected].