Transgender actress Alexis Arquette died from a heart attack, a death certificate obtained by Entertainment Tonight has revealed. It also revealed that Arquette had been living with HIV for 29 years.

The 47-year-old actress, who came from a family of actors including David, Rosanna, Richmond and Patricia Arquette, was surrouned by her family when she died on 11 September in Los Angeles. She was 47.

Richmond broke the news of his sister's death in an emotional Facebook post, revealing that her final moments were spent listening to David Bowie's Starman.

"Our brother Robert, who became our sister Alexis, who became our brother Alexis, passed this morning September 11, at 12:32 am," he told fans. "He was surrounded by all of his brothers and sisters, one of his nieces and several other loved ones."

According to the newly released medical documents, although a cardiac arrest was Arquette's immediate cause of death, HIV is noted as an underlying cause of death. ET reported that she suffered from bacterial endocarditis – an infection of the heart – for three weeks before her death, a common complication for those living with the disease.

Arquette's most famous roles include a Boy George impersonator, in the 1998 Adam Sandler romantic comedy The Wedding Singer, as well as trans sex worker in 1989 drama Last Exit to Brooklyn. She also had small roles in Buffy the Vampire Slayer, Pulp Fiction, and Threesome.

Arquette was credited with bringing increased awareness to the transgender community having lived as a women since her late teens. In 2007 her transition was documented in the programme, She's My Brother.