James Gandolfini Heart Attack Details Revealed

"The Sopranos" actor died on vacation in Italy at the age of 51.
3:44 | 06/22/13

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Transcript for James Gandolfini Heart Attack Details Revealed
She tells in the final moments of actor James Gandolfini and autopsy. Now concerns that the 51 year old star worth repeating only 51 years old the star of The Sopranos died of a heart attack. In Italy earlier this week. And a family says Gandolfini spent a typical vacation day with his son visiting the Vatican and having dinner at their hotel with no sign anything was wrong. Here's ABC's Alex -- park. This morning a clearer picture has emerged of Gandolfini is final hours -- this Rome hotel after spending Wednesday touring the Vatican with thirteen year old son Michael. They settled into a meal here waiting for Gandolfini sister to arrive. They were supposed to attend a film festival in Sicily. But three hours later the 51 year old actor had a sudden heart attack of natural causes. It has stunned those close to him including friend Michael -- -- Jim was really happy guy especially because you just have a baby daughter eight months ago he and his wife. He was extremely happy. And that he was healthy is nothing wrong with them it's -- this came as good a total surprise and shock. The autopsy found no signs of substance abuse the family has also -- tabloid stories. But The Sopranos star had a decadent final meal that could have led to his death. Cobalt and Gandolfini Stanley are now working with the Italian government to get the body of the three time Emmy winner -- the United States as soon as they can. They're also reflecting on the man that he was. We heard they were in trouble if you could do something if you saw a possibility he would intervene this was -- I think you can always tell people there has been an outpouring of affection for Gandolfini by his Hollywood colleagues. So gentle in rooms a gentle giant and I'm just. Had a magnificent -- -- lost him a great actor certainly vote would have look we -- a great man good things to say. New Jersey governor Chris Christie has ordered the flags at all state buildings to be flown at half staff on Monday in honor of their native son. The Gandolfini Stanley hopes to be back in the states in the next few days have the funeral in New York by the end of the week. -- Alex thank you so many medical questions about this story so let's bring in ABC's chief health and medical editor doctor at best forgotten. Thanks come in pretty great fear of 61 years -- -- can't get over that how unusual is that I think I think it's more common than most people would think -- Each year more than 101000 people under 55 die of a heart attack. And here we don't know much about his medical -- -- but we haven't heard reports that he was experiencing heart problems in the past is it unusual that he would just have this massive heart attack now. Well from one -- every two men and two at every two women who die of a heart attack had no symptoms before that so. You really need to know your risk factors -- high blood pressure high cholesterol. Are you a smoker diabetes obesity and -- someone in your family die of heart disease when the when they were also -- those two things -- -- -- -- greatest risk when -- in the moment what can you be watching -- we know that crushing -- -- -- shooting on your arm is on the lookout for White -- well there atypical symptoms they're more commonly seen women -- -- -- indigestion especially unusual indigestion or sleeping problem. -- pain in your neck -- error or in your back. Or shortness of breath with some exercise you have those things you wanna call 911. -- I'm having a heart attack to an aspirin and and then wait for somebody did to come for you. -- with a sad story like this seat there's a -- meet you can pay T can and that's. To make a small change in your life this weekend to go out for a walk -- weekend. Without any so that -- -- small baby steps. Can make a big difference in your heart disease risk wells -- Mike Hanna thanks -- appreciate it.

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

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