'Sopranos' Star James Gandolfini Was 'Practically Dead' at ER Arrival

Dr. Claudio Modini believes the beloved "Sopranos" actor died of a heart attack.
2:07 | 06/21/13

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Transcript for 'Sopranos' Star James Gandolfini Was 'Practically Dead' at ER Arrival
We're going to turn to the doctor's frantic efforts to save the life of james gandolfini. The actor was rushed to the hospital on wednesday, after suffering cardiac arrest in his hotel room. An autopsy is being done this morning to determine the exact cause of death. And abc's alex marquardt is in rome with the latest this morning. Good morning, alex. Reporter: Good morning, josh. This is the morgue where the autopsy of james gandolfini has taken place. We're told by officials it started early this morning, 36 hours after the hollywood star collapsed and died. We're told the family is expected to get the autopsy results today. This photo taken by an american tourist is the last known picture of gandolfini. The 51-year-old appears in good spirits. The actor reportedly had a dinner at his hotel, which included fried prawns, with a side of foie gras. A few hours later, michael called the front desk, pleading for help. They attempted to revive the actor before rushing him to the emergency room. The doctor in charge of the e.R. Told lama hasan that emergency personnel spent 20 minutes trying to revive gandolfini at the hospital. How would you describe his condition? Would you describe it as critical when he arrived here? More than critical. Practically dead. Reporter: Gandolfini had admitted to struggles with addiction. But was believed to have been clean for years, while continuing to smoke. Increased weight and regular smoking extraordinarily increases the risk of heart disease in anyone. Reporter: The three-time emmy winner talked about his weight issues and how ate affected the character of tony soprano. When I do get thin, I don't walk the same. He doesn't walk the same, with that lumber. Yeah. Reporter: We know that some of gandolfini's family is here in rome. But before the italian authorities can release the body, the u.S. Embassy has to issue a death certificate.

This transcript has been automatically generated and may not be 100% accurate.

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