Rich Piana died on August 25, 2017, at the age of 46 after collapsing at his home while getting a haircut. He was placed in a medically induced coma for two weeks before passing away
. The autopsy revealed that Piana had significant heart disease, including an enlarged heart (cardiomegaly) and hardened arteries (coronary atherosclerosis). Both his heart and liver weighed about twice the average for an adult male, which are known side effects of the anabolic steroids and hormones he openly admitted using
. However, the exact cause of his death was ruled "unknown" because toxicology tests could not be performed. The hospital discarded the toxicology specimens before they could be analyzed, preventing a full determination of whether drugs contributed to his death. While drug involvement could not be ruled out, there was no definitive evidence linking his death directly to drug use
. In the days before his collapse, Piana showed warning signs such as shortness of breath and nausea, which his girlfriend later identified as possible indicators of an impending cardiac arrest
. In summary, Rich Piana died from complications related to significant heart disease and organ enlargement likely associated with his steroid use, but the precise cause remains officially undetermined due to the lack of toxicology data.
