Shay's heart tissue to get closer look by medical examiner

NEW YORK -- An autopsy of elite runner Ryan Shay was
inconclusive Sunday after the 28-year-old collapsed and died in
Central Park at the U.S. men's marathon Olympic trials a day

"We want to take a closer look at the heart tissue," said
Ellen Borakove, spokeswoman for the city medical examiner's office.
She said the office likely would reach a conclusion in a week after
examining Shay's tissue on microscopic slides.

Shay collapsed about 5½ miles into the race Saturday, and later
was pronounced dead at a city hospital.

"They know how he died ... of a cardiac arrest. What caused it
is what's in question," his father, Joe Shay, told The Associated
Press. "We certainly want to know that as soon as possible. When
we know that we'll release that to the public as soon as we can.
We're patient."

Joe Shay said Saturday that Ryan was diagnosed with an enlarged
heart at age 14. But doctors had repeatedly cleared him for
competition, because having a larger than normal heart is not
unusual among elite athletes. Training hard in aerobic sports, such
as cycling, running or swimming, tends to result in a bigger heart
that pumps more blood throughout the body.

Dr. Douglas Zipes, a spokesman for the American College of
Cardiology who studies sudden deaths in athletes, said it can be
difficult to differentiate a normal athlete's heart from
potentially deadly hypertrophic cardiomyopathy.

Cardiac echo tests and electrocardiograms can help evaluate
whether the heart is healthy or not, said Zipes, a distinguished
professor at the Indiana University School of Medicine. Genetic
testing can also determine whether a person is at risk for certain

Still, those precautions may not catch everything.

Joe Shay said doctors could not adequately test Ryan using a
treadmill when he was a teenager because his heart rate was so low.
Zipes said that's not uncommon among elite athletes.

Zipes will sometimes have athletes stop training for a month in
an attempt to learn why their hearts are enlarged. Healthy
athletes' hearts will shrink during that time. The size won't
decrease if they suffer from hypertrophic cardiomyopathy.

Ryan Shay and other top athletes underwent medical testing in
Flagstaff, Ariz., where he trained, last spring, his father said,
and he was cleared for running.

"He said the doctors told him that because your heart rate is
so low, when you're older you may need a pacemaker to make
adjustments on that," Joe Shay said.

Ryan didn't complain of any problems, his father said, but he
never was one to do so.

"One of the issues is athletes often ignore warning signs you
or I might pay attention to," Zipes said, "because they are so
pushed to achieve a particular end point."

A memorial service for Ryan Shay was to be held Sunday either at
an area church or in the gymnasium at Central Lake High School in
Michigan's northern Lower Peninsula, Joe Shay said. He said his
son's professional coach, Joe Vigil, and his college coach at Notre
Dame, Joe Piane, were to deliver eulogies.