How holidays can be a health HAZARD: Heart attacks soar while travelling abroad, expert warns Heart problems are one of the leading causes of death for those on holiday Sopranos actor James Gandolfini, 51, 'suffered attack' on holiday in Rome Experts say people in holiday mode eat and drink and move more All could contribute to more physical and mental stress on the body Heart problems - such as those which are believed to have killed Sopranos star James Gandolfini - are the leading cause of death for those on holiday, it has today been claimed Heart problems - such as those which are believed to have killed Sopranos star James Gandolfini - are one of the leading causes of death for holidaymakers, it has today been claimed. While the stress-free environment of a summer holiday seems an unlikely backdrop to have a heart attack, experts warn that the crowds, polluted air, extreme temperatures, unusual foods, excessive alcohol and an increased amount of exercise found abroad could all contribute. Actor James Gandolfini, 51, who died earlier this week, was on holiday in Rome when it is believed he suffered a cardiac arrest. Officials have yet to confirm the cause of death with an autopsy. According to a 2003 paper published in journal Psychosomatic Medicine, a holiday includes 'out-of-the-ordinary activities' and could be responsible for placing extra physical and mental stress on the body. It said this can trigger a heart attack or other life-threatening heart problems. People can also become unhealthily upset when their dream holiday does not turn out to be quite how they had expected. The study looked at 92 Dutch people who had heart attacks while on holiday . It found that heart attacks were more likely to occur during the first two days of the break than on other days, Live Science reports. Dr. Erik Altman, director of electrophysiology at the North Shore-Long Island Jewish Southside Hospital in New York, said there was growing evidence suggesting it is common for those on holiday to have heart attacks. He said: 'The physical and emotional aspect of traveling and vacationing may need to be brought to people's attention. While we are on vacation, we are still at risk of heart disease. While the stress free environment of a summer holiday seems an unlikely backdrop to have a heart attack, experts warn that the crowds, polluted air, extreme temperatures, unusual foods, excessive alcohol and an increased amount of exercise found abroad could all contribute Altman said it could also be because people in 'holiday mode' may eat too much, drink too much and forget to take their medication. The details of the cause of Mr Gandolfini's suspected attack are not yet known, but news reports have suggested it could be in part down to his weight and smoking habit. Dr Altman has said that while heart attacks are not uncommon on holiday, overall, people who take regular vacations are less likely to die from heart attacks. He suggested people who have health conditions should 'adjust their holiday to suit their needs.'