In an e-mail to Shay, Ellen Borakove of the New York City medical examiner's office wrote:
Ryan's cause of death is cardiac hypertrophy with patchy fibrosis of undetermined etiology. Natural causes.
Shay was 28 at the time of his death. The autopsy made no mention of the toxicology tests performed on Shay after his death. However, his father said that he had "been 100-percent assured that the drug testing was negative." In other words, no foreign substances had been discovered. The full toxicology report will be contained only in the full, written autopsy.
I am happy to know that Ryan was clean and did not die from performance enhancing drug use. I am sad though, that such a healthy, fit young guy could just keel over and die leaving behind grieving family and friends. It's scary to think that what happened to Ryan could happen to anyone.