Cause of Death Remains Undetermined

Cause of Death Remains Undetermined

Rich Piana’s Autopsy Report: Undetermined Cause of Death Raises Questions

The autopsy report of renowned bodybuilder Rich Piana failed to establish the cause of his untimely death at the age of 46. The report highlights the lack of toxicology analysis and numerous potential contributing factors, leaving the question of what led to his demise unanswered. Piana’s passing in August sparked widespread speculation about his alleged drug use, including anabolic steroids and insulin. However, without the necessary toxicology reports and due to his reported heart disease and drug use, the autopsy was inconclusive in determining the exact cause of death.

Possible Factors and Uncertainties Surrounding Piana’s Death

The Florida District Six Medical Examiner’s Office, which conducted the autopsy, cited Piana’s known heart disease and drug use as potential factors that could have played a role in his death. The report revealed cardiac enlargement, significant heart disease, and mild coronary atherosclerosis. Piana’s heart was found to be twice the size of an average man’s, weighing approximately 670 grams. Additionally, he weighed over 290 pounds and had impressive 23.5-inch arms.

Unfortunately, the hospital did not retain the necessary admission samples for toxicology analysis, rendering it impossible to rule out drug use definitively. The director of investigations, William Pellan, explained that hospitals generally dispose of these samples after three days, an unfortunate practice in cases like Piana’s. Despite requests from both the police and the medical examiner’s office to preserve the samples, it was too late to obtain them for analysis.

Piana’s collapse while getting his hair cut led to his hospitalization, where he was placed in an induced coma for two weeks before passing away. The autopsy report did not directly link his death to drug use, but the lack of admission samples made it impossible to rule out drug involvement. Guillaume Pellan, one of the investigators, emphasized that due to the lack of available admission samples, drug involvement could not be entirely dismissed. However, the autopsy results did not suggest that drugs directly caused Piana’s death.

The Role of Heart Disease and the Need for Toxicological Analysis

While the autopsy did reveal an enlarged heart and coronary atherosclerosis, or hardening of the arteries, which are significant signs of heart disease, it is vital to conduct a toxicological analysis to rule out any potential drug-induced effects. Piana openly admitted to using anabolic steroids but denied using insulin and certain other types of steroids. According to reports, police discovered 20 bottles of steroids in his house after his death.

Piana’s transparency regarding his steroid use and his advocacy for legitimate bodybuilding practices earned him a massive following on social media platforms such as Instagram, where he had over a million followers, and YouTube, where his videos amassed nearly 28 million views. Despite his steroid use, Piana’s death serves as a reminder of the risks associated with such substances and reinforces the importance of transparency and awareness in bodybuilding practices.


The autopsy report on Rich Piana’s death left many unanswered questions, failing to establish a definitive cause of his passing. With no toxicology analysis available and numerous potential contributing factors, the exact circumstances surrounding his death remain uncertain. However, the report did reveal an enlarged heart and signs of heart disease, necessitating further investigation through toxicological analysis. Piana’s death serves as a reminder of the potential risks of using steroids and the need for transparency and awareness in the bodybuilding community.


Q: Did Rich Piana’s autopsy report determine the cause of his death?

A: No, the autopsy report was inconclusive in establishing the exact cause of Piana’s death.


Q: Was drug use ruled out in Rich Piana’s autopsy report?

A: Due to the lack of available admission samples, drug involvement could not be entirely dismissed.


Q: What were the significant findings in Rich Piana’s autopsy report?

A: The autopsy revealed an enlarged heart and mild coronary atherosclerosis, indicating heart disease.


Q: Did Rich Piana openly admit to using steroids?

A: Yes, Piana was open about his use of anabolic steroids.


Q: What is the importance of transparency in bodybuilding practices?

A: Transparency helps raise awareness of the risks involved and promotes safer bodybuilding practices.

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