Frank Sinatra Jr. died of a sudden heart attack in the middle of a tour, a stressful situation that could have contributed to his death, a top doctor says.

“When you’re an entertainer, being on the road is very punishing. You aren’t eating right, your sleep is disturbed, and you encounter all kinds of stressful situations. For anyone who might have heart disease, this is a very dangerous situation,” Dr. Chauncey Crandall tells Newsmax Health.

Sinatra Jr., died Wednesday at Halifax Medical Center in Daytona Beach, Fla., after going into cardiac arrest following massive heart attack. He had been admitted that afternoon after complaining of being lightheaded, TMZ, the online news site, reported.  The singer was in the middle of touring, having performed in Miami Friday night. He was scheduled to perform that night in Daytona Beach and then travel on to a concert date in St. Petersburg. 

Sinatra was the only son of Frank Sinatra, the iconic crooner who died of a heart attack at the age of 82, after suffering heart problems for several years. “Genetics gave him heart disease, and stress likely pulled the trigger.  Anything could have done it – singing, tugging at a suitcase, the pressure of being on the road,” adds Crandall, chief of the cardiac transplant program at the Palm Beach Cardiovascular Clinic in Palm Beach Gardens.

A heart attack is most often the result of atherosclerosis, which is the biological process that causes heart disease.  Fatty deposits, called plaque, form on the heart’s coronary arteries, narrowing them.  If a bit of plaque ruptures, a clot can form, which blocks the flow of blood to the artery, resulting in a heart attack.  If it’s a massive heart attack, this can put the heart into ventricular fibrillation, a dangerous heartbeat irregularity that can cause the heart to stop, resulting in cardiac arrest and sudden death.

The elder Sinatra, often pictured through a cloud of cigarette smoke, was famous for his hard-drinking lifestyle, and it’s likely that his son followed in his father’s footsteps, at least to some degree.  “If you have a family history of heart disease, you really have to stick to a disciplined lifestyle and it’s very, very difficult to do that when you’re an entertainer,” adds Crandall, author of the Heart Health Report.

Although not heart-related, Sinatra Jr. did have his share of health problems. A prostate cancer survivor, he was diagnosed in 2012, with advanced throat cancer, a form of the disease linked to cigarette smoking and alcohol use.  He underwent chemotherapy and radiation, which were successful, and then went back to working on his tribute to his father, “Sinatra Sings Sinatra,” which he was touring with when he died.