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Shay died on Nov. 4 while competing in the Olympic Trials Marathon in New York City.

ÊÊÊÊ "Ryan's cause of death is cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis of undetermined etiology. Natural causes," she said in an email to Ryan's father, Joe Shay, on Tuesday.

Ryan's toxicology report was 100 percent clean, as was expected by those close to him.

Ryan's autopsy report confirms earlier speculation that his enlarged heart contributed to his death.

In a phone interview on Tuesday, Joe Shay said that Ryan's autopsy also revealed that his heart had scar tissue, but doctor's could not say from what.

"They (doctors) speculate that it could have been previous heart attacks," Joe Shay said. "There was something that caused damage to his heart. All they know is that it (the scar tissue) is old.

"The doctors told me that when they've seen that type of thing (scar tissue), there's always a cause and effect. But they can't figure out where Ryan's previous heart damage came from."

Joe Shay said that the Medical Examiner's Office has been receiving a high number of calls concerning his son.

"I hope it (the report) gives the public peace of mind, especially the running community," he said. "Most marathoners are older-in their thirties and forties and fifties-so for a young guy to die unexpectedly in a race at the zenith of his career can be a shock. I think a lot of it (concern) is out of fear for their own mortality."

Shay said that the report also gives him and his family some closure and that he is grateful to the Medical Examiner's Office.

"This (the report) has been done by the greatest medical professionals, probably in the world," he said. "And I know that there's nothing more that could have been done, so that gives me peace of mind."

The full autopsy report will be released in two weeks to the Shay family.