Medical examiner points to aortic dissection in Lindsey Graham's death

The Medical Examiner of the District of Columbia released preliminary findings Sunday of US Senator Lindsey Graham's death, finding that he suffered an aortic dissection due to arteriosclerotic cardiovascular disease. The medical examiner said the death certificate will remain pending until toxicological and microscopic testing are finalized, at which point it will be updated to reflect the cause and manner of death.

The tear in the inner wall of the aorta was related to the hardening of Graham's arteries. The Senator's office had originally said he suffered from a brief and sudden illness.

US President Donald Trump said Graham was "like a member of the family," recalling that Graham called him Saturday night after returning from Ukraine and sounded "a little bit tired, but perfect."

Trump ordered flags flown at half-staff through Saturday evening.

Graham's death narrows the Senate Republican majority to 51 votes amid the ongoing absence of

Senator Mitch McConnell, who is recovering from injuries sustained in a fall as well as mild pneumonia.

McConnell said Graham was "a good friend and a great American," adding that he was "shocked and saddened by his passing." The former Majority Leader said Graham's colleagues and constituents "counted on his straight talk, conviction, and boundless appetite for a worthy fight," and that he and his wife Elaine were keeping Graham's family in their prayers.

After the announcement of his death, Politicians from around the world offered their condolences, including the leaders of Israel. President Isaac Herzog wrote that he was "shocked and heartbroken" to learn of the passing of "the great American patriot" and "my dear friend." Herzog called Graham "a beacon of moral clarity and a true leader of the US-Israel partnership," adding that "we will remain eternally grateful for his sense of justice, truth, and loyalty."

Meanwhile, Israeli Prime Minister Benjamin Netanyahu wrote that "Lindsey understood that the security of Israel and America are inseparable." He added, "Israel has lost one of its greatest friends. America has lost a great patriot. I have lost a beloved friend."

Graham spent his final weeks laying groundwork for a push to normalize relations between Saudi Arabia and Israel. In one seemingly foreboding report, Axios says a person who spoke with Graham Saturday night said he complained of feeling unwell but planned to seek medical attention Sunday morning after his scheduled appearance on "Meet the Press." Graham joked, "I can't die now. I still need to do the Russia sanctions, get Iran sorted out, and do Israeli-Saudi normalization." He passed away several hours later.

Under South Carolina law, Republican Governor Henry McMaster will appoint a temporary replacement for Graham. A special primary is required within weeks, with the winner of November's general election beginning a full six-year term in January. Names circulating as possible successors include Representatives Nancy Mace and Ralph Norman, Lieutenant Governor Pamela Evette and Representative Russell Fry.