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"Specifically what happens with a heart attack is a blood clot forms attached to that cholesterol plaque and basically slams shut the artery," said Dr. Peter Pelikan, cardiologist.
Dr. Pelikan says despite what we know about all of the risk factors of heart disease a heart attack can still sneak up on you.
"For many people the first symptom of a heart attack is death. They don't have a period of time when they are getting increasing chest pain or an increase of shortness of breath. The first symptom in many people including people in the 50s and 60s is sudden death," said Dr. Pelikan.
A different type of heart attack does not involve blockage, but rather a malfunction of the heart's electrical system.
The National Institute of Health says this kind of cardiac arrest occurs most often in people in their mid-30s to mid-40s. It affects men twice as much as women.
Dr. Pelikan says that most heart attacks in Jackson's age group are from blockages in the coronary artery.
"They may come out of the blue in someone who hasn't seen a doctor and has no symptoms. The bottom line is absence of symptoms does not mean you do not have heart disease," said Dr. Pelikan.
As we have been reporting Michael Jackson has died at the age of 50. Again we do not know if he has had a classic heart attack, but the question lingers how someone physically thin and active suffer one. Doctors say that just because someone is thin does not mean that you are healthy. You can be a top athlete and still have a heart attack.