Sen. Lindsey Graham (R-S.C.) died Saturday from an aortic dissection caused by arteriosclerotic cardiovascular disease, according to the Washington, D.C., Office of the Chief Medical Examiner.
Officials said Sunday that the death certificate will remain pending until toxicological and microscopic testing are complete.
“The death certificate will be PENDING until all the toxicological and microscopic testing are finalized and at that point the death certificate will be updated to reflect the cause of death and appropriately classify the manner of death,” the office of Dr. Francisco Diaz, the District's chief medical examiner, said.
Graham's office said the 71-year-old senator died after a "sudden and brief" illness.
“Senator Graham’s family appreciates prayers at this time and asks for privacy during this incredibly difficult period,” the statement said.
The South Carolina Republican had served in the Senate for more than 23 years after first winning election in 2002. He was one of the chamber's most recognizable Republicans and remained active in foreign policy until the final days of his life.
A joint statement from the medical examiner's office and the Metropolitan Police Department said toxicological and microscopic testing is still underway. Officials noted that toxicology tests, which determine whether any substances were present in a person's system, take time to complete.
According to scanner audio obtained by NBC News, emergency crews were dispatched to Graham's Capitol Hill home Saturday night for a report of cardiac arrest. EMS personnel performed CPR at the scene. Photos obtained by NBC News showed paramedics taking a person from the home on a stretcher as police and fire crews responded.
Just one day before his death, Graham met with Ukrainian President Volodymyr Zelensky during a visit to Ukraine while the Senate was in recess. He returned to Washington on Saturday.
President Donald Trump said he spoke with Graham later that evening, shortly after the senator arrived back in the capital.
“He sounded a little tired, but perfect. But a little bit tired, he had a right to be,” Trump said during NBC News' Meet the Press.
An aortic dissection is a tear in the inner lining of the aorta, the body's largest artery. Blood can force its way through the tear, separating the layers of the artery wall. The condition is a medical emergency and is often fatal if not treated immediately.
According to the Mayo Clinic, aortic dissections most often occur in men in their 60s and 70s. Symptoms can include sudden, severe chest or upper back pain, intense abdominal pain, or loss of consciousness.
Cardiovascular disease is the leading cause of death in the United States and worldwide. People with a family history of heart disease face a higher risk of developing cardiovascular disease. Graham's father, Florence Graham, died of a heart attack at age 68.
