March 18, 2008–NEW YORK–Joe Shay received official word Tuesday what caused his son’s sudden death Nov. 3 at the U.S. Olympic marathon trails. But four months of testing on Ryan Shay’s heart tissue samples, by some of the nation’s leading cardiology forensic experts and geneticists, left unanswered the biggest question: Why?
According to a statement by the New York City’s medical examiner’s office, Ryan Shay, a distance star from Central Lake, died of "cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis of undetermined etiology."
"The heartbeat went into an irregular rhythm due to an enlarged heart with old scars," Ellen Borakove, public affairs director for the office of the chief medical examiner, told the Free Press in a phone interview. "It’s an unknown source — we’re not able to identify what caused the scarring."It’s a natural-cause death."
Ryan Shay collapsed and died 5.5 miles into the race in New York’s Central Park. In the months since, his family, including his wife, Alicia, and the running community have been waiting to learn why a well-conditioned and seemingly healthy 28-year-old marathoner would be stricken in a sport he had done for years.
"They just don’t know what caused it," said Joe Shay, Ryan’s father and high school coach. "Fibrosis is scarring of the heart. It could have been from a heart attack. It could have been a virus — he was diagnosed with an enlarged heart at 14, when he had pneumonia. They just don’t know."
Joe Shay said the toxicology report, the results of which he learned three months ago but couldn’t release, came back "100% clean."Sharlene Day, director of Hypertrophic Cardiomyopathy at University of Michigan Health Systems, said: "That statement alone—cardiac hypertrophy with patchy fibrosis—to me, is HCM. It’s a typical description. Fibrosis is the end stage of a lot of things—muscle cells have died."
HCM, a rare but frequent cause of sudden death in young athletes, is a condition in which the muscles of the left lower chamber of the heart thicken and enlarge. Day, a runner who has competed in marathons, said she had not seen Shay’s autopsy report but was familiar with his case.
Joe Shay said he had made a request to the New York medical examiner’s office that his son’s heart samples "be archived so that in five or 10 years we might know why" he died. Shay also said that the family allowed a genetics expert at Harvard Medical School to study his son’s tissue samples.
"As far as getting the e-mail today, it was a relief that I could finally get the information to the public," Shay said. "The medical examiner’s office did a wonderful job preparing us (to understand) what the results were going to be. Harvard, all the outside cardiac forensic specialists, so many people looked at it. I think all that could have been done, was done."
Ryan Shay, who last summer married Alicia Craig, also a world-class runner, was one of the top runners the state has produced. He was the first Michigan boy to win four state cross-country titles. He went onto Notre Dame and became a 9-time All America and 2001 NCAA champion in the 10,000 meters.
In 2003 he became he youngest U.S. men’s marathon champion in 30 years when he won the title at 23.
Nearly everyday, Joe Shay said he and wife, Susan, go to visit their son’s grave. "I went up yesterday," Joe Shay said. "The first thing we do is say a prayer. We are totally convinced, both of us, that Ryan is touching our hearts and God has spoken to us that he is well."