More detailed posts and insights on Ryan Shay and sudden death during exercise:
- Initial views and theories for sudden death – article published within the first hours of Shay’s death
- Biography of Ryan Shay – performances and achievements
- Sudden death in runners – isn’t exercise supposed to protect the heart – a discussion of Alberto Salazar’s heart attack earlier this year. Likely a different cause to that of Shay…
- Screening as a means for prevention – post written after the death of a young Spanish soccer player earlier this year
- Sudden death during exercise – what does it mean for YOU? – discussion about screening, testing and avoiding exercise that might be dangerous
As all of us still try to accept the tragic death of Ryan Shay during the USA Men’s Olympic Marathon Trials, the cause of death has not yet been determined by the medical examiner’s office. An autopsy was performed on Sunday but was not conclusive.
Ruling out a heart attack
Although inconclusive, one thing we can say is that Shay’s death was apparently not due to any kind of coronary artery disease that would result in a heart attack—that is, the arteries supplying blood to the heart become clogged and the heart does not receive sufficient blood and oxygen. Instead the lack of any significant finding at this point suggest that the cause of death was cardiac arrest, which is when the heart stops pumping due to electrical imbalances. All the available evidence to date suggest this and includes that fact that Shay collapsed suddenly and also that he is below the age of 35.
In our post on Saturday night, we discussed how circulatory problems, like coronary artery disease, are responsible for most sudden deaths in older athletes, whereas younger runners usually experience electrical problems leading to sudden death. The two main reasons for these electrical failures are Hypertrophic Cardiomyopathy (an enlarged heart) or abnormalities in the coronary circulation. Ryan Shay was apparently diagnosed with an enlarged heart, but we also did point out that all athletes have larger than normal hearts, so even that is not a telling indication of the cause.
Adrenal Fatigue Syndrome?
According to a recent article on Runner’s World Shay was told in 2006 that he had “Adrenal Fatigue Syndrome,” the main consequence of which appears to be a fall in cortisol production. While possible Shay really had this, it appears unlikely to feature in the cause of his death, although it might warrant a post in The Science of Sport in the future.
In the mean time we must wait for the histology results to come back from the ME’s office in New York. They will examine the tissue microscopically to check for any signs of pathology that might be responsible for his untimely passing.
Friends and fans of Shay should visit the LetsRun.com official remembrance thread in their discussion forum. Barely 24 h after his death there are over 16 pages of remembrances and tributes, which indicates clearly that he will be missed by everyone in the US running community.