Were there warning signs before James Gandolfini's shocking death at age 51?
A photo shows him looking out-of-breath, leaning against a lamppost near his New York City home in March.
And he was sweating profusely while playing poker at an L.A. fundraiser in April.
We spoke to cardiologist Dr. Steven Reisman, director of the New York Cardiac Diagnostic Center.
"What this picture tells me is that Mr. Gandolfini, who of course was a great actor and it's a tragic loss, looks like was obsese and obsesity is one of the risk factors of heart disease."
Gandolfini was a hulking figure and overweight. He admitted to abusing cocaine and alcohol during the early years of The Sopranos.
"Cocaine causes vasoconstriction of the blood vessels going to the heart and to the brain and that, in fact, cocaine use can cause an accute constriction with a heart attack or a stroke."
He also enjoyed smoking, a leading cause of heart disease, and frequently smoked cigars on The Sopranos.
Now the world is asking if there are lessons to be learned from the acclaimed actor's untimely death.
"I hope that this is a wake up call for people. You can be going about your activities, out with your children enjoying the day, and that night have a heart attack," ABC Chief Medical Correspondent Dr. Richard Besser said.
Gandolfini used a cane to walk last year and it's unclear why. And he isn't the first public figure to suffer heart problems at an early age.
NBC's Meet the Press host Tim Russert was 58 when he died from a massive heart attack in 2008.
Former President Bill Clinton was 58 when he underwent quadruple bypass surgery in 2004.
And Late Night host David Letterman was 52 when he had quintuple bypass surgery.
In 2000, an emotional Letterman memorably thanked his doctors for saving his life.
Sadly, when James Gandolfini collapsed in his Rome hotel room, it was too late to save him.
Dr. Besser is the author of Tell Me the Truth, Doctor and has this advice if you think this is happening to you:
"If you think you may be having any sign of a heart attack, go ahead and chew an aspirin and call 911."
For more information on heart attack warning signs and prevention, go to: heart.org