While nothing has been officially released, sources have told TMZ that Randy "'Macho Man' Randy Savage" Poffo's autopsy was completed yesterday with inconclusive results pending the results of the toxicology screening, which will take four to six weeks to be completed. The medical examiner didn't find any "extensive trauma," so it seems like the car accident didn't kill him, the "medical event" that caused the accident did. I'm not sure if this means that he didn't have a heart attack (or some other event that would cause him to lose control of the car like a seizure) and they're looking at an external cause or that he did and they want to rule out contributing causes.
The elephant in the room since it was announced that he had a heart attack was whether or not previous use steroids and/or other bodybuilding drugs were a factor. Realistically, they had to be. Before he was Randy Savage, he was considered too small to be a major star. In the '70s, he did one set of WWWF TV tapings as a job guy where he blew away his peers, but considered too small to move to a higher level. He got bigger around the time of changeover to being Randy Savage in the late '70s, got much bigger in the WWF, and even bigger from when he was 46 years old in 1999 through some point before his TNA appearance where he showed up much smaller and wouldn't take off his jacket. Wrestling Observer Newsletter editor Dave Meltzer mentioned Wednesday that it seemed like Savage had seen and listened to a doctor who told him that he badly needed to be clean of the bodybuilding drugs as soon as possible.
When Savage "retired" in 1991, his plan was reportedly to get of steroids and try to conceive a child with Elizabeth, but for whatever reason, they weren't successful. With the WWF getting serious about drug testing, he appeared to be clean from his return through the rest of his WWF run as he wrestled with a top added to his ring gear. On talk shows, he would admit to having "experimented with anabolic steroids when they were legal." When he jumped to WCW, he was in great shape and back to just wearing tights.
Unfortunately, it's a forgone conclusion that the Medical Examiner found an enlarged heart in Randy Poffo's body. Most likely, consistently using steroids in huge bodybuilding dosages for two decades or so minus a 3+ year gap in the early '90s. If the cause of death wasn't a heart attack or other heart issue, though (and the TMZ post isn't clear), then I'm not sure what the Medical Examiner is looking for short of some kind of drug overdose or poisoning. At any rate, we won't know for sure for a month or so.