Cardiology expert links Daniela Espírito Santo’s death to emotional distress of domestic abuse incidents
A cardiologist has testified that severe emotional distress likely played a critical role in the death of a domestic abuse victim.
Dr Richard Andrews, a cardiology expert at Lincoln County Hospital, gave evidence on the seventh day of the inquest into Daniela Espírito Santo, of Chestnut Grove, Grantham, today (Wednesday).
A post-mortem examination had earlier in the inquest said Daniela died following an acute deterioration of an existing heart condition, which she had lived with and for which she had attended numerous medical appointments and check-ups to monitor the situation.#
Dr Andrews was asked to review the reports, along with Daniela’s medical history, to determine the impact of partner Julio Jesus’ reported assaults on her prior to her death in the early hours of April 9, 2020.
He confirmed that she suffered from chronic myocarditis, which causes problems with the heart and makes it harder to pump blood around the body. This included scarring from previous incidents on the left ventricle.
Dr Andrews told the jury: “It’s clear that in the minutes prior to Daniela’s death she was very distressed.
The National Domestic Violence Helpline is a 24hr Freephone available on 0808 2000 247 operating 24 hours a day, seven days a week.
“Daniela’s extreme state of distress after the second assault and everything with her heart more than minimally contributed to her cardiac arrest.”
He pointed to the telephone transcript and audio of Daniela’s calls to 999 prior to the event.
“It’s evident that Daniela was extremely emotionally distressed, and it’s clear in scientific papers that patients who have scar tissue in their heart, and who become extremely emotionally distressed, have a high rate of sudden death.”
Dr Andrews also concluded that the first assault, for which Mr Jesus was originally arrested, did not more than minimally contribute to the death compared to the second assault.
The jury has been asked to decide if an assault took place prior to Daniela’s death, and senior coroner for Greater Lincolnshire Paul Smith asked Dr Andrews if he felt the level of emotional distress was equivalent to a verbal or physical altercation.
Dr Andrews said he felt the level of emotional distress “would be greater than a simple verbal dispute”.
Daniela was prescribed two specific medications to tackle her heart condition, including beta blockers, which had been stopped during her pregnancy, and not restarted following the birth of her second child.
However, Dr Andrews felt that had she been taking the beta blockers, there would only have been a small reduction in the risk of sudden death.
The counsel for Lincolnshire Police also asked Dr Andrews if an incident on November 11, 2019, when Daniela became unwell while officers were visiting after a previous report of domestic assault, could be linked to her heart condition.
Dr Andrews said it was possible that there had been a “transient cardiac disturbance” due to the emotional distress Daniela was suffering on that day as well.
On that occasion, Daniela had refused a police offer to call an ambulance and had seemed better after taking a moment to breathe and being offered some water, according to police reports.
Mr Jesus was arrested by police on April 8 following a report of domestic assault by Daniela earlier that morning, which included her first formal complaint.
The jury has already heard what he said in his interview before being released on bail later the same day.
He was given conditions not to attend [the house number in] Chestnut Grove or to contact Daniela following his release, shortly before 6pm on April 6. Daniela was phoned to tell her of Mr Jesus’ release and the conditions. However, he breached those bail conditions shortly afterwards.
The jury today was read a summary of Mr Jesus’ interviews with police after he was arrested on suspicion of murder following her death. The jury was warned that the statements he made were not necessarily the truth of what had happened.
Mr Jesus has also not engaged with the inquest, with Mr Smith noting he was “beyond the jurisdiction of this court,” as he is believed to have returned to his home country of Portugal.
He said the summary was “an accepted record of what he said,” but added, “the family do not accept the truth of what he said”.
In the interviews, Mr Jesus said that after he had been released on police bail, he had gone to Asda and described texting and calling Daniela before returning to the flat, where he said she had let him in.
He described how the evening had started relatively peacefully, with him playing with their two children and taking a nap before 7pm.
He noted that around 8pm to 8.30pm Daniela had told him she felt unwell, and he had suggested they call an ambulance.
He revealed in the interviews that he was aware of her heart condition and noted its impact when she got too stressed, adding that when “she gets upset or stressed, I try to go out and away from her,” which he said was to allow her to calm down.
At one point, he acknowledged he knew he was “not supposed to be at the flat yesterday”.
However, he said an argument broke out later that evening between 10pm and 11pm over messages from one of his sisters.
He said this escalated into her having his car key and him having her phone before both threw them to the ground.
He said Daniela had tried to stop him from leaving, but he had moved her out of the way.
He said he told her he was leaving and never coming back, and she said he was never going to see his children again.
He denied he had used excessive force but acknowledged he had touched her to move her out of the way. He later clarified he may have “left a little mark”.
He also told police that Daniela had “a temperament,” adding that the couple did not have much money, and “sometimes we have arguments.”
The jury will hear from one final witness, Dr Jackie Sebire, tomorrow (Thursday), a policing expert who will be analysing the force’s responses to the history of incidents.
The inquest continues.
