Christina Sandera — the longtime girlfriend of Clint Eastwood — died of a heart attack, the Monterey County Health Department has reportedly confirmed . Her immediate cause of death was listed as cardiac arrhythmia, a disorder in which, according to the Mayo Clinic, the electrical impulses in the heart malfunction and cause an abnormal heartbeat. Atherosclerotic coronary artery disease was listed as an additional condition leading to her death, according to a Tuesday report in the New York Post.

Eastwood announced Sandera’s death in a statement last Thursday, although no cause of death was given at the time. She was 61 when she died July 18. Sandera was on the board of directors for the Monterey Bay National Marine Sanctuary Foundation, where she served as the chief developer, and manager of a world-class equestrian center in Carmel Valley.

“Her commitment to both land and marine animals was truly inspiring,” the organization said in a statement on Instagram. Sandera and Eastwood hosted their annual Sea Stars Gala; the statement said she “eschewed the spotlight,” despite being connected to the high-profile Oscar winner. “She was a ‘roll up your sleeves’ kind of person, always hands-on and deeply involved in her passions,” the chapter director of the foundation said.

Eastwood, 94, and Sandera dated for a decade, and kept their relationship largely private. They reportedly met at Eastwood’s Mission Ranch Hotel and Restaurant, where Sandera worked as a ho.