Officials said that an American tourist who died at a resort in the Dominican Republican succumbed to a heart attack, although her symptoms were similar to two other Americans who died there about a week later.
Holmes and Day also suffered from internal bleeding, including in their pancreases. Holmes also had an enlarged heart and cirrhosis of the liver, which indicated a pre-existing condition, CNN reported. Day also had fluid in her brain, the report said.
“We are deeply saddened by the incident at one of our hotels in La Romana, Dominican Republic, and want to express our deepest condolences to their family and friends,” Bahia Principe Hotels said in a statement after the deaths of Holmes and Day.
The Dominican Republic’s prosecutor’s office said forensic experts are performing toxicological and other tests to determine the causes of death of Holmes and Day.
Police said several bottles of medicines to treat high blood pressure were found on the scene of the couple’s death.
On May 27, the pair had shared photos and messages on their Facebook accounts in which they appeared to be enjoying their vacation.
McDonald said Schaup-Werner’s family heard about the deaths of Holmes and Day, who he said checked into the hotel the same day as Werner and Schaup-Werner.
“He was understandably in shock but the whole thing was just so stunning,” he added.