Usually it’s heart failure, but you’re not going to know for sure unless you do an autopsy. But who wants to go to the trouble of performing an autopsy on a 90 year old? It’s a 99% chance it was heart failure. But quite frankly we just don’t care enough to go to the effort to confirm it when someone is old.
As you get older your body starts to fail. When your heart fails, that it, game over.
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