John Fetterman dominated the Pa. Democratic Senate primary. Here’s how he won.

John Fetterman didn’t just win in Pennsylvania, he trounced his Democratic Senate primary rivals. The lieutenant governor won every single county in the state and had a 30-point lead over U.S. Rep. Conor Lamb with almost 94% of the expected total votes counted Wednesday.

He did it even with a late and shocking development: Fetterman suffered a stroke days before the primary and spent election day recovering in the hospital.

His victory was so decisive, it became a footnote amid a tight GOP Senate race that was still too early to call Wednesday and likely headed for a recount. And while predicted by polls and political observers, his win represents a clear shift away from the more moderate candidates Democratic voters typically favor in Pennsylvania primaries.

Fetterman tapped into a growing populist electorate in Pennsylvania, combining that appeal with a progressive message. He got into the race early and set up an unbeatable fund-raising operation. And his “every county” strategy — combined with a social media campaign and TV ads — blanketed his brand statewide.

In many ways, Fetterman’s nomination flips the script on the kind of Democrat Pennsylvania has recently nominated. But more historically, outsiders have often done well in the state’s primaries, including Ed Rendell, Joe Sestak, and even Tom Wolf.

And a lot of Democrats, aware of a political environment in which the party has lost voters to Donald Trump’s GOP, saw Fetterman’s outsider profile as a plus. In a year when Democrats are expected to struggle, Fetterman’s pitch that he could appeal to a wide base clearly resonated.

That also undercut Fetterman’s strongest opponent, Lamb, whose message had been that he and his more moderate approach would be the most electable.

» READ MORE: 5 takeaways from the Pennsylvania primary election

Fetterman also ran a campaign laser-focused on voters, whereas Lamb mined the political establishment for endorsements and the support of lawmakers.

“He wisely focused on winning support from Democratic voters, as opposed to the Democratic establishment,” Democratic strategist J.J. Balaban said. “At a time when Democrats are frustrated with politics as usual, Fetterman’s approach matched the political moment and struck Democrats as different. He ran effective ads that credibly built on that image.”

Fetterman set his campaign up extremely well by being the first Democrat to announce in the race and netting the early cash windfall that followed. He vastly out-raised his opponents in a year when Democratic fund-raising isn’t as robust as when Trump was in the White House.

The haul was a notable improvement from his last Senate run in 2016, when he ran on a shoestring budget.

Fetterman came in with the highest name recognition thanks to his time as mayor of Braddock and lieutenant governor. Traditionally, Pennsylvania’s second-in-command hasn’t gone on to political prominence, but Fetterman spent his one term building his brand through a statewide marijuana decriminalization tour and his work at the Board of Pardons.

He also got on people’s radars in an unsuccessful 2016 bid for Senate.

All of that, Balaban said, “along with his literally larger-than-life persona, helped him to enter this race with a big lead … a lead he never lost.”

It was clear early in the race that Fetterman had turned from candidate to celebrity, and his wife, Gisele, was a part of that appeal.

Supporters at Fetterman rallies often stuck around to take photos with her. And no other candidate’s spouse was as visible on the campaign trail.

After John Fetterman was hospitalized with a stroke last week, Gisele Fetterman delivered a victory speech for her husband, faced reporters at the polls, and appeared on TV the morning after his win.

Fetterman led the fund-raising in the primary, but he’s about to face a multimillionaire in the general election, whether it’s celebrity doctor Mehmet Oz or former hedge fund CEO David McCormick.

» READ MORE: The Pa. Republican Senate primary is probably headed for a recount

Fetterman ran a strong campaign, but it was also an expensive one. And now he’ll need to expand it, which means more money. He’ll have help from his party, but so will either Oz or McCormick, neither of whom is a stranger to spending big. Their campaigns and allied groups spent more than $50 million in the Republican primary, much of it blanketing Pennsylvania with television ads.

As returns rolled in, Fetterman was in a Lancaster hospital with his father and brother. His campaign said Tuesday that he underwent a procedure to get a pacemaker to regulate his heart rate.

While the stroke didn’t seem to drive down support for Fetterman — it likely came too late in the race to make an impact — it has already raised questions about how active he can be on the campaign trail.

How opponents might try to question his health and aptitude for the job is also a looming issue.

The campaign, which has offered few details on Fetterman’s health, didn’t respond to several requests to interview Fetterman’s doctors. But it has said that doctors reversed the stroke in time to prevent any cognitive damage and that Fetterman is expected to make a full recovery.

» READ MORE: Fetterman got a pacemaker following stroke

Gisele Fetterman told reporters Tuesday that her husband’s health should not be an issue.

“Anyone who would imply that he would be unfit to serve because of this procedure is also ... offending millions of Americans who have pacemakers,” she said.

Republicans have already started trying to depict Fetterman as a “radical progressive,” despite his largely aligning on the issues with the Democrats he faced in the primary.

American Rising PAC, a Republican political action committee, sent out an email shortly after Fetterman’s win calling him a “Bernie-endorsed” “true progressive.”

“John Fetterman is trying to rebrand himself from a ‘true progressive’ to ‘just a Democrat’ as he goes head-to-head against the Republican nominee in Pennsylvania’s U.S. Senate race,” the group said. “But a quick look at his record shows that ‘progressive’ has been a significant part of Fetterman’s identity for years, and he is much too radical for a state that Joe Biden only won by 1.2%.”

Many of Fetterman’s positions are common in the Democratic Party — including a $15 minimum wage, elimination ofthe filibuster, and access to abortion without exceptions — and are likely to be attacked by his Republican opponent. While he hassaid he would support “Medicare for All,” Fetterman has also said hewould support a more modest plan to help drive down costs and expand coverage.

Fetterman was endorsed by Sen. Bernie Sanders in his 2018 race for lieutenant governor, an alliance Republicans will likely try to use against him.

In 2013, Fetterman pursued a man and pulled a shotgun on him because he believed the man, who turned out to be a Black jogger, had been involved in a shooting. Fetterman, who was then Braddock’s mayor, has long defended his actions, saying he heard gunfire nearby and made a split-second decision to act in what he thought was an “active shooter situation.”

» READ MORE: What to know about the 2013 John Fetterman jogger incident

An officer who responded to reports of gunfire searched the man and found he was unarmed, according to a 2013 police report.

Fetterman’s opponents slammed him over the incident, but it also seemed like a nonfactor in his primary run. Does it resurface and gain more traction in a general election?