Queen Elizabeth II sent a message to Pakistan's President Sunday expressing her heartfelt sympathy as the country dealt with the aftermath of a huge earthquake that killed thousands. About 19,500 people were killed when the magnitude 7.6 quake rocked Pakistan, India and Afghanistan Saturday. The greatest number of deaths were reported in northwestern Pakistan and Pakistan-controlled Kashmir. "I was shocked to hear of the devastating earthquake which has caused such destruction and loss of life in Pakistan," the Queen said in a message to President Gen. Pervez Musharraf. "I send my heartfelt sympathy to you and the people of Pakistan, especially to the bereaved and injured and all who have been affected by this terrible disaster."