Really...the only patients that I've seen with such premature cardiac disease had diabetes. A structural defect would have been caught with team physicals-unlike regular folks, MLB players routinely have ETTs and/or/echocardiograms
Steroids can also cause premature atherosclerosis. Cocaine can, too, as well.
I just Googled Jose Lima and heart problems-the result is only the current event. So, unless you can find the link that elucidates Lima's cardiac disease that existed Saturday, I think the board certified internist knows a bit more. In any case, toxicology takes about 6 weeks to come back. I can't imagine any ME willing to certify a death in a 37 y/o without an autopsy