I am not a doctor, but I do conduct death investigations and am a deputy medical examiner. I have been to numerous autopsies. The pathologist performing the post is the most important variable, and the quality of labratory testing, if any is done. A cardiac event may or may not leave physical evidence detectable at post. In the event of a massive heart attack, the clot that causes it can often be found in the heart. All manner of things can kill you that are undetectable at post, also many pathologists do not open the skull in all cases, so any number of things can be going on inside the head that never get looked at.
I have no experience what so ever with autopsy of DCS victim so I have no idea what you would or would not see.
In answer to the above post, swallowing water will not drown you. Inhaling it can and does.
There is a somewhat rare, but not unknown reaction where inhaling very small amounts of sea water can cause trachea constrictions, which result in suffocation. leaves behind absolutely no physical evidence. I've seen one event of this (person lived thankfully) and there has been one that I know of in the last 2 years in florida (but only because their were witnesses to the event. ) How often this is assumed to be heart attack is not known. My guess is that when they don't know, and you are over around 40... it is assumed to be heart attack.