Official Ryan Shay Autopsy Results Are Here

ok, where are the cardiologists to interpret?

wejo wrote:

http://www.letsrun.com/2008/ryan-shay-autopsy-0318.php

Cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis of undetermined etiology.

Natural Causes.

Mr. Shay said the toxicology report was negative

anEconomist wrote:

ok, where are the cardiologists to interpret?

wejo wrote:http://www.letsrun.com/2008/ryan-shay-autopsy-0318.php

Cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis of undetermined etiology.

Natural Causes.

I'll give it a start from talking to Mr. Shay. Cardiac arrhythmia is supposedly just the electrical imbalances in the heart. Cardiac hypertrophy is his enlarged heart. I think patchy fibrosis is the tough part. It could be from anything from a virus when he had pneumonia as a kid or from previous heart attacks.

I think the bigger picture is that life is precious and we can't take our time here for granted. In the West, it seems like we want a perfect explanation for everything, when I was in Kenya last year, it was apparent death was accepted as a part of life. So I don't think we'll have a perfect explanation of what happened but doctors will give their best shot.

I guess that puts an end to these threads

No test for drugs can certify Shay or anyone else as clean. We'll never know the true story. So just let Shay rest in peace.

Yes, that may be the take away, I guess as much as we are sorry for the loss of Ryan, many of us would like an explanation so that we can relate it to us as runners today. Are we vulnerable? etc.I guess my only reaction to the first two statements - cardiac arrhythmia and cardiac hypertrophy - those were a given. You tell me what wrong in a healthy person's heart and I would have said those are good candidates.Here the fibrosis is the interesting one. Did Ryan have a bad bout of pneumonia as kid? I guess these are things we'll never know the cause of.

wejo wrote:

anEconomist wrote:

ok, where are the cardiologists to interpret?

I'll give it a start from talking to Mr. Shay. Cardiac arrhythmia is supposedly just the electrical imbalances in the heart. Cardiac hypertrophy is his enlarged heart. I think patchy fibrosis is the tough part. It could be from anything from a virus when he had pneumonia as a kid or from previous heart attacks.

I think the bigger picture is that life is precious and we can't take our time here for granted. In the West, it seems like we want a perfect explanation for everything, when I was in Kenya last year, it was apparent death was accepted as a part of life. So I don't think we'll have a perfect explanation of what happened but doctors will give their best shot.

RE:Cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis of undetermined etiology.

Natural Causes.

I'm a quarter-mile runner who was recently diagnosed with H.C.M. at the beginning of my Senior year of college so I know a little about what is being said...

"Cardiac arrhythmia is just the beating and rhythm of the heart."

"Cardiac Hypertrophy" is another way of saying Hypertrophic Cardiomyopathy. Its a condition where the septum, which is the muscle between your left and right ventricles becomes enlarged. Thus shrinking your ventricles and making it much more difficult to pump blood to the rest of your body. If this becomes severe enough, it will cause your heart to start beating irregularly and could potentially give you a heart attack.

The arrhythmia due to cardiac hypertrophy is pretty much benign the way I see it as far as pathology goes. If not associated with HCM, or other conditions, then it likely was an inherent condition that he had from a mixture of being an athlete and some possible genetic predisposition. The patchy fibrosis is likely what caused his rhythm disruption if I was forced to guess. Weight loss supplements can cause fibrosis, many of which act on the some cells(fibroblasts) in our heart that make collagen. This is the cause for too many tragic deaths do to high levels of weight loss in sort periods via a supplement.

However, while I believe Ryan was on a diet supplement?? I would be slow to jump on this theory as an autopsy would likely be able to distinguish this type of fibrosis.

The real issue here though is we as a runnning commuity lost a great person, and a wonderful talent. And like Wejo mentioned death is the only linking thing between everyone in this world. That and life I guess. So lets all be ready, whatever that might mean in our lives, and hopefully the Shay's can grieve in peace now and find some sort of reconciliation.

My thoughts and prayers are with you..

M.Lane wrote:

"Cardiac Hypertrophy" is another way of saying Hypertrophic Cardiomyopathy.

FALSE

The real question is whether or not these results can rule out that he wasn't on performance enhancing drugs. If he were, would there be some sort of 'red flag' in the results that would make it obvious to most doctors?

I don't see how anything in this report sheds light one way or another. Would there be a way to distinguish between products purchased at GNC vs. rhEPO? How about HGH?

What would someone be looking for in the autoposy report to answer these questions?

Doesn't the fact that NONE were found in his body count for at least a little clean-ness?

No Test wrote:

No test for drugs can certify Shay or anyone else as clean.

“The heart beat went into an irregular rhythm due to an enlarged heart with old scars,” Ellen Borakove, spokesperson for the medical examiner’s office, told the Free Press by phone Tuesday. “It’s an unknown source – we’re not able to identify what caused the scaring.

“It’s a natural cause death.”

This the best explanation. There are no other causes for the heart failures as in performance enhancing drugs or recreational drugs. Plain and simple!

why did it take so long for the results?

It just seems like there are some people who will clutch at anything other than a natural cause in this case. I think it scares some people here to think that an apparently healthy runner could go down like that. They'd rather dirty him up than accept that,

And where is the history of PEDs of a sort that he might have taken and this type of death? It is not part of the literature and unless you can make that linkage you are a f****** troll. Go Away, far away.

The real ? wrote:

The real question is whether or not these results can rule out that he wasn't on performance enhancing drugs. If he were, would there be some sort of 'red flag' in the results that would make it obvious to most doctors?

I don't see how anything in this report sheds light one way or another. Would there be a way to distinguish between products purchased at GNC vs. rhEPO? How about HGH?

What would someone be looking for in the autoposy report to answer these questions?

42kmike wrote:

why did it take so long for the results?

Probably because they were comparing tissue samples of the fibrosis.

The causes of cardiac fibrosis range from the more common - like infections from bacteria or viruses - to the extremely rare, genetic diseases, ingested chemicals, etc.

When looking at this stuff under a microscope, you've got to compare it to known samples, and that can take time. Even the best pathologists in the world can disagree about the patterns and potential causes.

On a side note, I had the chance to spend some time working with some of the patholigists and other doctors at the Armed Forces Institute of Pathology (AFIP) in Bethesda. It's basically the clearinghouse in the USA for all types of wierd diseases, conditions, and causes of death.

Prominent pathologists and docs from all over the country would come and review cases, and often times you'd have substantial disagreements over the causes. There were times when there would be a room full of docs who would be split between 2 or 3 potential causes.

When dealing with rare events, it's often impossible - even for experts - to say for sure what's going on.

Care to try that again with a coherent sentence?

If you reread my post I am not speculating one way or another, nor am I offering my opinion.

I am merely asking how one might interpret these results to firmly state that he was or wasn't on PED's.

Again, how does sharing the autopsy report prove his case one way or another?

The real ? wrote:

Care to try that again with a coherent sentence?

If you reread my post I am not speculating one way or another, nor am I offering my opinion.

I am merely asking how one might interpret these results to firmly state that he was or wasn't on PED's.

Again, how does sharing the autopsy report prove his case one way or another?

My apologies for jumping to the wrong conclusion. You might phrase things a little differently to avoid misreads like mine, but the mis-read was my fault.

M.Lane wrote:

I'm a quarter-mile runner who was recently diagnosed with H.C.M. at the beginning of my Senior year of college so I know a little about what is being said...

"Cardiac arrhythmia is just the beating and rhythm of the heart."

"Cardiac Hypertrophy" is another way of saying Hypertrophic Cardiomyopathy. Its a condition where the septum, which is the muscle between your left and right ventricles becomes enlarged. Thus shrinking your ventricles and making it much more difficult to pump blood to the rest of your body. If this becomes severe enough, it will cause your heart to start beating irregularly and could potentially give you a heart attack.

This is a very patchy explanation. Cardiac arrhythmia is a basic heading for a variety of abnormal heart rhytmns. My guess is that Ryan went into some sort of sustained ventricular tachycardia around when he passed out, which progressed to cardiac arrest or the deadliest arrhythmia, ventricular fibrillation.

The arrhythmia being caused by cardiac hypertrophy. There are a variety of different hypertrophys, with Left Ventricular Hypertrophy(LVH) being the most common. This is because in athletes your left ventricular pumps the blood out through your aorta to your body. When you are working hard, obviously this ventricle is pumping harder and faster to get more blood to your muscles. Was Ryan's hypertrophy LVH? who knows. he could have had a viral infection when he was a child that caused a cardiomyopathy. it could have been a congenital defect that went un-noticed. There are nutritional and hypertrophys caused secondary from systemic diseases. The bottom line is that you don't know what his heart was enlarged from and probably won't.

Saying that cardiac hypertrophy is another way to say hypertrophic cardiomyopathy or HOCUM as we call it, is also ignorant.

While you are correct in your defintion of HOCUM, you are wrong in saying that its another way of saying cardiac hypertrophy. HOCUM usually effects young men and is normally found before the age of 20. ALthough I had a patient last week diagnosed at the age of 65. Like i stated above its just a heading for a variety of conditions.

My best guess is that Ryan had some sort of Cardiomyopathy secondary to viral infection as a child, coupled with LVH. This caused his ejection fraction to drop while running, heart stopped getting the blood it needed to function properly, went into sudden cardiac arrest, no one there to defibrilate, and we all know the end story.

RIP.