Donda West, mother of rapper Kanye West, apparently died of a heart attack, according to the coroner’s final report. TMZ.com reported Thursday (January 10) that the Los Angeles County Coroner has concluded that “coronary artery disease and multiple post-operative factors due to or as a consequence of liposuction and mammoplasty” led to her sudden death two months ago.

In its preliminary autopsy report, the coroner’s office suggested West may have died “as a result of surgery or anesthesia.” At the time of West‘s passing, a family spokesperson announced she died “as the result of complications from a cosmetic surgical procedure.

The popular celebrity surgeon who operated on her, Dr. Jan Adams, defended his procedure saying, “When she left [my] office, there was no problem whatsoever.” He offered the alternate possibility of an overdose on the painkiller Vicodin he prescribed for West. She “probably [had] a rough night,” after the operation, Adams said, and had complained of pain the very next morning. Asked whether he thought West may have taken too many of the painkillers, Adams said, “That’s one speculation on my part, yes.

Although according to TMZ reports, the final manner of West‘s death “could not be determined,” the coroner’s initial findings did not mention drugs as a possible link to her death.

The coroner’s office had been investigating possible complications from a cosmetic-surgery procedure involving breast reduction, abdominoplasty (commonly referred to as a “tummy tuck”) and liposuction.