Margaret Pettitt, 53, deputy headteacher at St Thomas of Canterbury Primary in Newport, Isle of Wight, died weeks after tripping on the school stairs while preparing for the inspectors' arrival.
After the fall, doctors told her to rest and elevate her left leg.
But with the 88-pupil RC school fighting to escape special measures, she returned to work for the two-day inspection in November 2005.
Laura Fairhurst, then headteacher at the school, told Mrs Pettitt to take the time off, but the committed deputy head was concerned about the impact of her absence. Mrs Fairhurst said: "Had there not been an inspection, she probably would not have come in over those two days. There wouldn't have been the same pressure."
The day after the inspection ended, she returned to hospital, had a plaster cast fitted, and returned home for nine days but was later diagnosed with a pulmonary embolism and deep-vein thrombosis.
Mrs Pettitt's condition worsened and she suffered four heart attacks. She died on December 6, 2005. Two days later, Ofsted said the school had made good progress since being put in special measures.
Delays in admitting Mrs Pettitt to hospital and administering medication prompted the coroner, John Matthews, to enter a verdict of accidental death contributed to by neglect in June.
Her husband David, a former director of children's services at Isle of Wight council who could not be contacted this week, said after the verdict that he would be seeking legal advice.
Mick Brookes, general secretary of the National Association of Head Teachers, said Mrs Pettitt's return to work was an extreme example of the pressure that teachers felt under Ofsted's inspection regime.
An Ofsted spokesperson said: "We would like to express our sympathies to the family, friends and colleagues of Margaret Pettit."