He died at the age of 46, after two weeks in a coma. At death, his heart and liver weighed over twice the average amount for an adult male, and he had "serious heart disease". He had been aware that his organs were enlarged and that is a known side effect of the steroids, hgh, insulin and other hormones he had been taking. There was also significant hardening of the arteries and plaque in his arteries coronary atherosclerosis. He also had abnormally yellowish skin color, fatty liver , ascites accumulation of protein-containing fluid in the abdomen , congested thyroid , congested and discolored kidneys , ischemic brain tissue brain tissue that had lost blood supply , necrotic brain tissue and brain edema.

By Chris Pleasance For Dailymail. Rich Piana's world is one of complete excess - from his sprawling houses, to his ten gut-busting meals per day and of course his utterly insane body. But that excess comes with a price-tag in the form of decades of steroid use in doses so extreme other bodybuilders have filmed hours of YouTube footage to begging him to stop. While the risks of steroid use are not lost on Piana, who frequently discusses them on his own YouTube channel, he insists he's happy with his life and the path he chose.

Rich Piana's estranged wife, Sara, has confirmed on Instagram that the year-old has died. The bodybuilding world is in mourning as one of its greats has passed away after being placed in a coma. In an emotional post, she said: "I'm in tears writing this that 1dayumay has just passed away.