Official Ryan Shay Autopsy Results Are Here

if he had a cardiomyopathy secondary to a viral injection, wouldn't that have been noticeable before now, and also prevented him from being as good of runner as he was.

second, what are you thoughts on the fibrosis?

question for doc wrote:

if he had a cardiomyopathy secondary to a viral injection, wouldn't that have been noticeable before now, and also prevented him from being as good of runner as he was.

second, what are you thoughts on the fibrosis?

No, not necessarily.

What we have from the autopsy report is limited. It mentions "patchy" fibrosis, but doesn't note how widespread it was.

Obviously, if it was extremely widespread, than it would prevent him from running at a high level. If it was more isolated, however, it might not affect him at all in terms of cardiac output, especially if his heart could compensate by getting bigger.

One scenario which is possible:

Shay has a viral illness while young that winds up affecting his heart. He grows with it, and does all the things an athlete does. His heart, slightly damaged, compensates by growing larger and thickening (cardiac hypertophy). It doesn't affect the ability to pump blood, but in time the hypertrophy gets so severe that it begins to cause abnormal electical conduction, i.e. arrhythmia.

And the stress of running is what finally tiggers the fatal arrhythmia. Just coincidence that it happened a couple into the Oly Trials, and not say, on a hard tempo, or a 15k race, or a while he's playing basketball in his backyard.

so a question, would this have killed him eventually if he weren't a runner? seems odd that it happened at such a 'downtime' in the race

just curious, was it just random when this was going to occur

anEconomist wrote:

so a question, would this have killed him eventually if he weren't a runner? seems odd that it happened at such a 'downtime' in the race

just curious, was it just random when this was going to occur

Can't say for certain whether running had something immediate to do with it. It's possible, but not definite. There are certainly people who die at advanced ages from something else, and they've got similar looking hearts.

What is known is that fibrosis due to an undetermined cause (a.k.a. idiopathic fibrosis) is responsible for nearly 25% of the sudden cardiac deaths in adults that aren't due to heart attacks. These can happen at any time, but seem to be linked more with exercise than would be by chance.

Looking at it logically, the case could be made that it was more a random occurance than exercise induced, since he presumably wasn't running at his max, but that's just guesswork and speculation.

This even made the front page of the Sports Illustrated website.

SPORTS / OTHER SPORTS | March 19, 2008

Heart Condition Led to Runner's Death

By AIMEE BERG

Ryan Shay, who dropped dead during the Olympic trial for the marathon, had cardiac arrhythmia caused by an enlarged heart and died of natural causes, according to the New York City medical examiner’s office.

___________________________

The article said he died from the condition stated above, and that there were ..."no drugs of any kind found in his system.."

(the full article is too long to post)

I read a study a few years back where they compared around 300 postmortem patients that died of sudden cardiac death(SCD)w/ patients that died non cardiac death and found that with the ones that died of cardiac death with idiopathic myocardial fibrosis, the ventricular interstitium was remodeled in a way that had a predisposition towards the L. ventricle infer. wall. this sort of supports my theory about some sort of viral infection causing the idiopathic fibrosis which could then account for LV (hypertrophy?)(i dont remember the exact findings of the LV changes) and decrease in cardiac output.

maybe murphy can provide some insight on this as well.

pvs wrote:

SPORTS / OTHER SPORTS | March 19, 2008

Heart Condition Led to Runner's Death

By AIMEE BERG

Ryan Shay, who dropped dead during the Olympic trial for the marathon, had cardiac arrhythmia caused by an enlarged heart and died of natural causes, according to the New York City medical examiner’s office.

___________________________

The article said he died from the condition stated above, and that there were ..."no drugs of any kind found in his system.."

(the full article is too long to post)

They didn't write it like that did they? "dropped dead" Tacky! Many posters on here were chastised when they phrased it like that. What do you want from someone named "Berg" as in ice berg!

Brad Kickster M.D. wrote:

I read a study a few years back where they compared around 300 postmortem patients that died of sudden cardiac death(SCD)w/ patients that died non cardiac death and found that with the ones that died of cardiac death with idiopathic myocardial fibrosis, the ventricular interstitium was remodeled in a way that had a predisposition towards the L. ventricle infer. wall. this sort of supports my theory about some sort of viral infection causing the idiopathic fibrosis which could then account for LV (hypertrophy?)(i dont remember the exact findings of the LV changes) and decrease in cardiac output.

maybe murphy can provide some insight on this as well.

I think this is tje one you are talking about:

http://heart.bmj.com/cgi/content/abstract/92/3/316

I haven't read the entire thing (I don't have remote access at my house to the BMJ, but will check tomorrow at work) so I can't really comment too much about it, except that it seems to be in line with what is being reported in the autopsy.

Since we only have those few lines - patchy fibrosis, cardiac hypertrophy and arrhythmia, we can only guess. The reports that Shay had an enlarged heart at age 14 (discovered on a chest X-ray for pneumonia) and later when evaluated after a car crash, certainly lead credence to the theory that it was present for a long time prior to him becoming an elite athlete.

Certainly a viral illness while young, scarring the heart, leading to hypertrophy and a result conduction abnormality makes sense logically, but it is still a bit of medical guesswork without more information.

actually i just found it. check it. pretty cool stuff. at least i think this is it. i haven't read the full txt, but the conclusion swings that way....

http://www.heartrhythmjournal.com/article/S1547-5271

(04)00095-5/abstract

NY Times article:

http://www.nytimes.com/2008/03/19/sports/othersports/19runner.html?_r=1&ref=sports&oref=slogin

Brad Kickster M.D. wrote:went into sudden cardiac arrest, no one there to defibrilate, and we all know the end story...

This is not true. Bystanders were immediately there to perform CPR, including at least one doctor, and an EMR crew was there within 5 minutes. So the question is, why weren't they able to restart his heart? Was it because the sinus node was inaccessible due to the enlargement and scar tissue?

I have read the description that he was dead when he hit the ground. While this might be a slight exaggeration, it does not seem like there was any time (or mechanism) for saving him.

may not have been quick enough. defibrillators are becoming more prevalent and i believe some schools have them now.

I might be wrong, but did his head hit the ground? And if so, would any trauma to the head have caused or accelerated his death in addition to the cause stated?

This scarring is scaring me. If it can be caused by an illness while young, how do we know that we aren't walking around with scarring to the heart, given that most of us have had some serious illnesses when young?

Is there a way to measure this (while alive)?

This might be the dumbest question ever asked, but can they date around how long he had those scars? Does carbon dating work for that kind of stuff?

I too wondered the same thing. Did they examine his head? take x-rays? MRI (Maybe too costly, but they could have saved money by switching to GEICO)? I haven't seen anything from the examiner's office but, I wonder if results include additional detail regarding procedures used in reaching their conclusion.

Sorry Ryan would frequently make GEICO jokes. .