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A cocaine overdose killed Johnny Wade Perry Jr., an eastern Wake County resident who was one of the best Strongman competitors in the world, according to an amended autopsy report released this week.

The report also stated that an enlarged heart might have contributed to Perry's death in November at the age of 30. Though the report did not say what caused the enlarged heart, medical experts say that condition is an occasional side effect of long-term steroid use.

Perry, who was ranked fourth- strongest in the world by the International Federation of Strength Athletes, which regulates Strongman competitions, died in his home near Zebulon. The competitions involve men pulling, lifting or carrying weights that often include planes, trains and automobiles.

At 6 feet 5 inches tall and 390 pounds, Perry was big even for a Strongman competitor. On the day he died, he was scheduled to catch a plane to Sweden for a competition.

The federation decided to institute more stringent drug testing after Perry's death.

The average heart size for someone of Perry's height and weight ranges from 365 to 463 grams, said Chief State Medical Examiner Dr. John Butts. Perry's heart weighed 620 grams, according to the report.

"Even though he's a big fellow, that's too big," Butts said.

An earlier report from the medical examiner stated that Perry had a drug salad in his blood, including high levels of cocaine and its byproducts, and the painkiller OxyContin and the "date rape" drug GHB. Perry's parents and a former girlfriend said in recent interviews that he had taken steroids, but that was in the past.

Dr. Richard V. Clark, director of metabolic discovery medicine at GlaxoSmithKline and an an expert on doping in sports, said steroids can cause a heart to grow larger than one would expect in a normal, well-trained athlete.

"Anabolic steroids at high doses induce muscle enlargement, and that's not just skeletal muscle but cardiac muscle as well," Clark said.

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