Serial killer Robert Black was a heavy smoker with high cholesterol when he died, a lawyer has told his inquest.
Black, 68, murdered four schoolgirls between 1981 and 1986.
He was a Scottish delivery driver who ranged across the UK in the 1980s and his victims were often found hundreds of miles from where they were abducted.
His inquest is being held in the same courtroom in Armagh city where he was convicted of the murder of Northern Irish schoolgirl Jennifer Cardy in 2011.
Black died at Maghaberry high-security prison in Co Antrim in January 2016.
Nobody from his family was present at his inquest and the Coroners Service was unable to trace anybody, coroner Paddy McGurgan said.
Stephen Ritchie, a barrister for the Coroners Service, said medics believed Black died from a heart attack after having a stroke 20 years earlier.
He said: "He was in his late sixties, a heavy smoker, with diabetes and high cholesterol."
Black, from Falkirk in Scotland, was serving a number of life imprisonment sentences.
In May 1994 he was convicted of kidnapping, raping and murdering three girls.
Susan Maxwell was aged 11 when abducted in 1982 near the border between Scotland and England.
Her body was gagged and bound and she was found 250 miles away, in England.
The former delivery driver travelled extensively, Mr Ritchie noted.
His next victim was a girl aged five, Caroline Hogg, who was abducted from Portobello in Edinburgh in 1983 and her body was found 300 miles away.
Sarah Harper, aged 10, was abducted in 1986 and found dead in the River Trent near Nottingham.
In 1981 Black abducted and sexually assaulted Jennifer Cardy, nine, from Co Antrim.
He was convicted in 2011.