Andy Irons, in a 2008 competition in Australia. (Steve Robertson / AP (Covered Images))

Irons’s body was discovered Nov. 2, 2010, in a Dallas hotel room. A copy of the autopsy was given to the New York Times by a publicist for Irons’s family and Dr. Vincent Di Maio, a forensic pathologist hired by the family, told ESPN: “This is a very straightforward case. Mr. Irons died of a heart attack due to focal severe coronary atherosclerosis, i.e., ‘hardening of the arteries.’ He had an atherosclerotic plaque producing 70-to-80 percent narrowing of his anterior descending coronary artery. This is very severe narrowing. A plaque of this severity, located in the anterior descending coronary artery, is commonly associated with sudden death.”

A heart attack related to his coronary artery disease was listed as the primary cause of death with “acute mixed drug ingestion” the secondary cause. Irons was one of the best competitive surfers, but rumors of drug use followed him throughout his career. He quit the tour in 2008, missed the following season and made a comeback last year.

Police discovered Alprazolam, an anti-anxiety drug, Zolpidem, a sleep aid and tablets containing methadone. According to toxicology tests, cocaine and methamphetamine were also present in his system. Although the Tarrant County (Texas) medical examiner’s office will not release the results until June 20, Irons’s family hired its own experts because of his medical history.

“Andy was prescribed Xanax and Zolpidem (Ambien) to treat anxiety and occasional insomnia — a result of a bipolar disorder diagnosed by his family doctor at age 18,” the family said in a statement obtained by the Times. “This is when Andy first began experiencing episodes of manic highs and depressive lows. The family believes Andy was in some denial about the severity of his chemical imbalance and tended to blame his mood swings on himself and his own weaknesses, choosing to self-medicate with recreational drugs.

“Members of his family, close friends, and an industry sponsor intervened over the years to help Andy get clean, but the effort to find balance in his life was certainly complicated by his chemical makeup.” After dropping out of a competition in Puerto Rico, Irons was en route to his home in Hawaii when he died.

Gallery: Andy Irons