History teacher Giulia Silva de Araújo, 26, died after being discharged twice in one day from a municipal hospital in the North Zone of Rio de Janeiro, Brazil, on Friday, August 28.
Relatives of the victim claimed that medical staff at Hospital Municipal Francisco da Silva Telles treated a potential heart attack as an anxiety crisis before releasing her.
Araújo first sought emergency care at the hospital complaining of chest pain and symptoms indicative of a cardiac condition, where she underwent multiple medical examinations before being sent home. She returned almost three hours later with identical symptoms, fell unconscious during her second evaluation, and was discharged again after further tests before suffering a fatal heart attack at another facility later that day.
Rio de Janeiro, the second most populous city in Brazil, operates a network of municipal hospitals designed to provide emergency medical care across its northern and southern sectors. Hospital Municipal Francisco da Silva Telles is one of several public urgent care facilities serving residents in the city's northern region.
Hospital discharge and double evaluation
According to details of the case, Araújo initially arrived at Hospital Municipal Francisco da Silva Telles presenting severe chest discomfort and clinical signs compatible with an acute cardiac event. Medical staff conducted several diagnostic examinations and subsequently authorized her initial release.
Fewer than three hours later, the 26-year-old teacher returned to the emergency department reporting the exact same physical distress. Hospital personnel ordered a second battery of tests, which included a complete blood count and a chest radiograph.
A complete blood count is a standard laboratory blood test used in emergency medicine to evaluate overall cellular health, checking for infection, inflammation, or anemia. A chest radiograph, commonly known as a chest X-ray, uses low-dose radiation to create visual images of organs inside the chest cavity, helping doctors inspect the heart, lungs, and surrounding blood vessels.
Family members stated on social media that Araújo fainted and experienced worsening, more severe symptoms while being evaluated during her second visit to the hospital. Despite her deteriorating condition, the medical team did not change her initial diagnosis and released her for a second time after completing the tests.
After receiving her second discharge, Araújo became severely ill again at home and was rushed to another medical facility closer to her residence. She suffered a fatal heart attack and died later the same day. Her death is now under investigation by detectives at the 59th Police Station in Duque de Caxias, a municipality located within the Greater Rio de Janeiro metropolitan area.
Hospital defense and official response
Management at Hospital Municipal Francisco da Silva Telles stated that the medical team provided full assistance to the patient in accordance with her clinical condition during each evaluation. Hospital officials insisted that Araújo was attended to promptly upon arrival with chest pain complaints and received all protocol-indicated care for immediate diagnosis of acute cardiac conditions.
The hospital administration reported that all of Araújo's vital signs and test results fell strictly within normal parameters. These included her heart rate, respiratory rate, blood pressure, body temperature, and blood oxygen saturation.
Hospital management added that Araújo underwent an electrocardiogram, described as a crucial test for detecting high-severity cardiac conditions, and that the result showed no abnormalities. An electrocardiogram is a non-invasive medical test that records the electrical signals of the heart to identify irregular rhythms, structural issues, or heart muscle damage caused by reduced blood flow.
In a formal statement, the Municipal Health Secretariat of Rio de Janeiro expressed sorrow over the death of Araújo and reiterated that all necessary medical care was provided based on her clinical presentation. Hospital management stated that it remains available to answer further questions from the family.
Differentiating cardiac events from anxiety
Dr. Natassha Fernandes, a cardiologist at Hospital Edmundo Vasconcelos in São Paulo, explained that heart attack symptoms do not always manifest in the classic manner of sharp chest pain radiating down the left arm. In some cases, initial warning signs can easily be mistaken for severe anxiety or gastrointestinal distress.
Fernandes noted that the most typical indicator of a heart attack, or myocardial infarction, is intense chest pain in the centre of the thorax that can spread to the arms, jaw, and back. Additional symptoms often include nausea, shortness of breath, heart palpitations, and a sensation of fainting. While physical exertion and emotional stress generally aggravate cardiac pain, anxiety attacks can produce nearly identical physical discomfort but without worsening during physical exercise.
A heart attack occurs when blood flow to a section of the heart muscle is severely restricted or blocked, depriving cardiac tissue of oxygen. Fernandes emphasized that clinicians evaluating chest pain must review risk factors for coronary artery disease, including high blood pressure, elevated cholesterol, diabetes, rheumatological conditions, positive family history, and the use of illicit drugs or anabolic steroids.
To distinguish between cardiac emergencies and non-cardiac conditions, emergency chest pain protocols require an electrocardiogram within 10 minutes of patient arrival, alongside blood tests repeated over several hours to monitor for cardiac enzyme changes. Fernandes stated that there are more than 10 differential diagnoses for chest pain other than a heart attack, requiring doctors to admit patients for emergency cardiac evaluation if any parameter shows abnormality. She added that anxiety serves as a diagnosis of exclusion, a clinical conclusion reached only after all life-threatening medical conditions have been thoroughly ruled out by diagnostic testing.
National heart attack statistics in Brazil
Data from the Brazilian Ministry of Health underscores the widespread impact of cardiovascular diseases across the country. According to official government figures, Brazil records between 300,000 and 400,000 cases of heart attack each year.
In 2025, deaths resulting from heart attacks reached 91,912 nationwide, solidifying heart attacks as one of the leading causes of mortality in the South American nation. Medical experts continue to stress the importance of immediate specialist evaluation whenever unexplained chest pain occurs.
