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To clarify in case of questions, I'm talking about Charles V, Holy Roman Emperor, King of Spain, etc., etc., from the early to middle 16th century.

Charles had many problems, including epilepsy, gout, couldn't chew food properly due to jaw deformations. Say any one of these things kills him before he becomes Holy Roman Emperor, so before 1519. What happens to his (IOTL) lands? What happens to the Americas? Who's elected emperor, and how do they lead?
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