SANTA FE, N.M.  — The main cause of Gene Hackman’s death was heart disease, but he was also in the advanced stages of Alzheimer’s disease and likely had not eaten for a long time, according to a new autopsy report.

The report documents the 95-year-old actor’s poor heart health, noting he had experienced congestive heart failure, an aortic valve replacement and an irregular heart beat. He was given a pacemaker in April 2019.

Hackman’s carbon monoxide concentration was less than 5% saturation, which is within the normal range. He tested negative for the hantavirus, which is a rare but potentially fatal disease spread by infected rodent droppings.

Authorities have said Hackman’s wife, Betsy Arakawa, likely died Feb. 11 at home from hantavirus pulmonary syndrome. Her autopsy report hasn’t yet been released.

A toxicology report says Hackman tested negative for alcohol and intoxicating drugs, but that he had a low concentration of acetone in his system that indicates prolonged fasting.

Hackman appeared to have outlived Arakawa at home by about a week, possibly unaware of his wife’s death. Hackman’s pacemaker showed an abnormal heart rhythm on Feb. 18 — the day he likely died, according to the state’s chief medical examiner.

Records released earlier in the investigation showed Arakawa made phone calls and internet searches as she scoured for information on flu-like symptoms and breathing techniques.

Recently released videos outline the scope of the investigation into the deaths of Hackman and Arakawa.

Before they understood how Hackman and Arakawa died, authorities recorded themselves conducting interviews with workers and returning to Hackman’s home to search for more evidence. Detectives searched the home in early March for Arakawa’s laptop and other clues.