Fast Running Blog

I have to admit the the length of time it was taking to get final word back on Ryan's cause of death was beginning to make me wonder, especially since his dad had been so public about getting toxicology tests done to prove his son didn't dope. I would have thought he would have been just as vocal about it when they came back negative. So now that issue is apparently put to rest:

New York Times
March 19, 2008
Heart Condition Led to Runner’s Death
By AIMEE BERG
Ryan Shay, the 28-year-old runner who collapsed and died in Central Park during the United States Olympic trials on Nov. 3, had cardiac arrhythmia caused by an enlarged heart and died of natural causes, according to the New York City medical examiner’s office.

More than four months after Shay’s death, the medical examiner completed the autopsy and toxicology reports, describing his condition as “cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis of undetermined etiology.”

Ellen Borakove, a spokeswoman for the medical examiner, said she could not comment on the specific results of the toxicology tests as a matter of policy, nor could she reveal what was tested for. Ryan Shay’s father, Joe Shay, said none of the toxicology tests were positive, although he did not know what tests were conducted.

“I believe it was a fair and accurate assessment,” said Joe Shay, who was told of the results by phone and e-mail messages and was awaiting a hard copy of the full report. “Everything that could be done was done, and it’s great that they devoted so much time to this.”

Shay had been diagnosed with an enlarged heart when he was 14 based on a chest X-ray taken when he had pneumonia. Two years later, Shay was in a minor car accident and had another chest X-ray at the same hospital.

“They compared the two X-rays and said his heart was getting bigger,” Joe Shay said.

Shay was the 2003 United States marathon champion. He ran a 2:14.08 personal best at the 2004 New York City Marathon, placing ninth, and was a viable contender to earn one of the three berths on the U.S. men’s team for this summer’s Beijing Olympics.

Shay collapsed five and a half miles into the race and was to Lenox Hill Hospital and pronounced dead at 8:46 a.m., while the 26.2 race was still underway.

Not to desecrate the memory of a great competitor, but I'd be interested to know what an enlarged heart means for an athlete. In horses, Sea Biscuit was said to have had an "enlarged heart" (it was, indeed, much larger than that of normal Thoroughbreds) which probably contributed to the physiology of his greatness. Breeders are continually searching for that abnormal gene in race horses. Is there a corresponding human abnormality? Just wondering.

Although I am glad to hear that all the toxicology reports came back negative, every time I think back to what happened, it is still a shock to me.  Thanks for the update - I have been wondering myself what was happening.  Runner's World actually had a little article from Amby Burfoot about this very subject just last week - basically asking the New York Medical Examiner's office what was taking so long.  Their reply was, in so many words, "leave us alone and let us do our jobs.  The report will be finished when it is finished."  This is probably small comfort to his family and widow, who at least know for sure now that he was not taking drugs.

Fredrick, Enlarged heart by itself in athletes is very common. Especially endurance athletes including marathon runners and cross-country skiers. It is a paradox in the medical community. Cardiac hypertrophy is seen most commonly in response to developmental growth, growth in response to endurance training, and in response to hypertension (high blood pressure). It can also be seen in growth hormone and thyroid disorders. However the outcomes are very different. The metabolite usage profile is also different. One chief problem with the heart is that new cells are not typically recruited so individual cells grow (hypertrophy). In exercise induced hypertrophy stopping the exercise you can reverse the size of the heart. Some studies claim that this is rare and others claim that it is a causative factor in sudden death syndrome in athletes. From many other sources however including some of my own studies the latter is just not true. In fact one of the most commonly used models in cardiac metabolic studies is chronic training to lead to exercise induced cardiac hypertrophy...
 

One of the more interesting bits from the article was the annoucement of patchy fibrosis, which suggests some illness that affected the heart tissue at some point.  The medical examiner's office thought that it was older, and his father thought that might have been from his bout of pneumonia.  However, the additional information in the article indicates that fibrosis on the heart muscle can actually lead to irregular heartbeat, as the fibroid tissue causes a disruption in the electrical impulse that goes through the heart muscle.  Interesting . . .

I saw this come out a couple days ago and my impression of things is that they never really got a good answer and are just making their best guess. Sometimes that is the best answer that we can get. Probably why it took so long.

ESPN had a feature on Ryan Shay's death - mostly a discussion with his wife about her life now.  It is a pretty good one to watch.  The address actually is an interesting article on Ryan Hall (w/ a little on his relation with Shay) and then there is a link to watch the feature on Shay.
http://sports.espn.go.com/oly/trackandfield/columns/story?id=3372422 (http://sports.espn.go.com/oly/trackandfield/columns/story?id=3372422)

INcredibly moving ESPN piece. Thanks for passing along. Here's a story that appeared in USA Today last week...

http://www.usatoday.com/sports/olympics/2008-05-01-shay-craig_N.htm