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  Most heart attacks occur when you have atherosclerosis, or plaque in the arteries of your heart. The plaque, which is lining the arteries – which are like pipes – ruptures like a pimple into the opening of the artery. A lot of patients don't have any symptoms until that sudden onset of this rupture. Because even though the artery has plaque, it's not restricting the flow until that minute when the plaque ruptures. Around a quarter million people die of a sudden heart attack each year, and about half are under 65. So Gandolfini's experience isn't that unusual. But you wonder, why did it happen to him? Well, we don't know his risk factors, but he certainly had one: He's been overweight and at times obese.
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