According to the document, Arquette was living with the disease -- the underlying cause of her death -- for 29 years. She suffered a bacterial infection of the heart three weeks before she died of a heart attack on Sept. 11 at the age of 47.
While Arquette transitioned to a woman in the early 2000s, her death certificate interestingly uses her full name, Robert Alexis Arquette, and lists male under sex.
Arquette's brother, Richmond, was the first to share the news of his sister's death.
"Our brother Robert, who became our sister Alexis, who became our brother Alexis, passed this morning September 11, at 12:32 am," he wrote on Facebook. "He was surrounded by all of his brothers and sisters, one of his nieces and several other loved ones."