Death of natural causality in middle age is almost always associated with these: heart risk factors (cholesterol, tri-glycerides, pressure, valves, arterial plaque/occlusion), untimely diagnosis of cancers, aneurisms, undiagnosed/untreated conditions, family history (genetics), exposure to exogenous toxins including vapors, liquids, bacterial, chemical, nuclear,blah blah blah. Or too much methamphetamine, cocaine powdered or free-based crack, heroin street opiates, acetaminophen, pasta alfredo, zabaglione, and all sorts of other good time charlies. Gandolfini was a large man and appeared to have large appetites of all sorts. Heck, he ate enough junk at the Bing to kill him.
Jams Gandolfini was a large man who lived life large. I have to believe that many of his 51 years were pretty good ones. Godspeed, Mr. G.
Heavy drinking of course is at least if not more destructive than most party drugs.