Autopsy: James Gandolfini Died of Cardiac Arrest

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James Gandolfini, 1961-2013.

UPDATED: The coroner's office in Rome has confirmed the 51-year-old "Sopranos" star died of a heart attack, as originally suspected.

TAORMINA, Sicily -- Sopranos star James Gandolfini died of a heart attack, hospital officials confirmed Friday at a press conference hosted by Gandolfini’s family in Rome’s Boscolo Hotel Exedra, where the family had been staying.

With the results of the autopsy now in hand, officials can officially issue a death certificate, clearing the way for Gandolfini’s body to be returned to the U.S. for burial.

Gandolfini, 51, died Wednesday night after spending what family assistant Tom Richardson said was a “marvelous day” touring Rome with his family. The family had been traveling in Italy before a planned stop in Sicily on Thursday to participate in the Taormina Film Festival, where the actor was expected to participate in a Master Class event on Saturday along with Pursuit of Happyness director Gabriele Muccino and actress Marisa Tomei. He was set to receive a special award that evening, the festival’s final day.
"James came here on a vacation with his family ... he had a wonderful day," said Gandolfini family spokesperson Michael Kobold. "He visited The Vatican and had dinner at the hotel with his son awaiting the arrival of his sister. Today we received the results of the autopsy, which stated he died of a heart attack, of natural causes. The autopsy further states that nothing else was found in his system. We are all devastated by this loss. James was a devoted husband, a loving father of two children, a brother and cousin you could always count on. We thank you for the privacy you have afforded us during this difficult time."
Mario Sesti, Taormina’s artistic director, said he spoke to Gandolfini just hours before he died: “He was so happy to be in Italy, to reconnect with his Italian roots, and he was very excited to come to Taormina and receive this award,” Sesti said.
Italian news sources have reported that the actor had a last meal of fresh gnocchi at Ristorante Sabatini in the bohemian Roman neighborhood of Trastevere.

Gandolfini’s parents were both born in Italy, though the actor himself was a native of New Jersey.
The news of Gandolfini’s death hit the 59-year-old festival hard. Festival officials reorganized Saturday’s events to include a Master Class about the actor co-hosted by Sesti and ’s Eric J. Lyman, and then a special homage to Gandolfini that night ahead of the international launch of The Lone Ranger, the festival’s closing film.

Richardson said Gandolfini returned to the hotel in good spirits Wednesday when he went to the hotel’s bathroom and “something happened.” Gandolfini’s 13-year-old son Michael immediately alerted hotel officials, who rushed to the room and called for an ambulance. Officials from Rome’s Policlinico Umberto I said Thursday that the ambulance arrived within eight minutes and that lengthy efforts to revive the actor were unsuccessful. He was reportedly announced dead at 10:40 p.m. local time Wednesday.
In addition to his son Michael, Gandolfini leaves behind wife Deborah Lin and nine-month-old daughter Liliana.
Gandolfini’s death sparked a massive outpouring of condolences from friends, admirers, and fellow actors and other industry figures.