Shefali Jariwala's Death Spotlights Rising Risk of Sudden Cardiac Arrest in Women: Experts Urge Increased Awareness and Screening

The unexpected death of Indian actress Shefali Jariwala has sparked widespread concern and highlighted a worrying trend: the increasing incidence of sudden cardiac issues among women. While the official cause of Jariwala's death awaits confirmation, initial reports suggest a cardiac arrest, a phenomenon that is increasingly affecting seemingly healthy, middle-aged women.

The Growing Crisis of Sudden Cardiac Death

Sudden cardiac death (SCD), once considered rare among young adults, is now a growing concern, particularly in India. Cardiovascular diseases account for approximately 28% of all deaths in India, with nearly 10% of these deaths attributed to SCD. A significant number of these fatalities occur in individuals between 30 and 50 years old.

India's rapid socioeconomic changes have led to widespread lifestyle changes, including:

• Sedentary lifestyles
• Unhealthy diets
• Tobacco use
• Increased stress levels

These factors contribute to a rise in conditions like hypertension, obesity, diabetes, and coronary artery disease, all of which are major risk factors for SCD.

While historically more prevalent among men, recent studies highlight the unique risks faced by women. Unlike men, women who experience SCD often have no prior cardiac diagnoses. Structural abnormalities, such as myocardial scarring and ischemic heart disease, frequently go undetected until post-mortem examinations. Many women also do not exhibit classic warning signs like chest pain or ECG anomalies, making early detection particularly challenging.

The Silent Threat to Women in Midlife

Women in their 40s and 50s face a significant risk from underlying cardiac conditions. In younger populations, SCD is often linked to inherited or electrical disorders, including:

• Hypertrophic Cardiomyopathy
• Arrhythmogenic Right Ventricular Cardiomyopathy
• Long QT Syndrome
• Brugada Syndrome
• Catecholaminergic Polymorphic Ventricular Tachycardia

These conditions often remain asymptomatic until a fatal arrhythmia occurs.

In this age group, additional risk factors include left ventricular hypertrophy, obesity, and myocardial fibrosis. The progression of myocardial scarring and fibrosis with age can be attributed to:

• Cumulative exposure to cardiovascular risks
• Repeated micro-ischemic events
• Hormonal changes, particularly during perimenopause

Conditions like Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), which are more common in younger women, often leave no trace in autopsies, further complicating diagnosis.

Jariwala's life, beginning as a teen star, was marked by considerable stress. Takutsobo cardiomyopathy (Broken Heart Syndrome), or stress-induced cardiomyopathy, is a major cause of SCD in women who multitask and experience emotional stress. Jariwala also faced personal challenges, including divorce, anxiety, depression, and epilepsy, all of which can impact cardiovascular health. Psychiatric medications, especially those that prolong the QT interval, have also been linked to an increased risk of SCD.

A Call for Gender-Specific Prevention and Increased Awareness

Despite the severity of the problem, women remain underrepresented in preventive heart care. Symptoms such as fatigue, palpitations, or breathlessness are often dismissed or misattributed, delaying critical intervention. While heart attacks are caused by blocked arteries, cardiac arrest results from electrical disturbances that cause the heart to stop suddenly. Immediate CPR and defibrillation are often the only lifesaving measures, emphasizing the importance of early risk identification.

Medical experts are now advocating for more targeted public health strategies, including enhanced early screening tools tailored to women, particularly during perimenopause when cardiac risks increase.

Honoring a Life, Igniting a Movement

The entertainment industry and fans mourn the loss of Shefali Jariwala. Her tragic death serves as a catalyst for change. Her passing underscores the often-overlooked health crisis of women’s heart health. It highlights the pressing need for a systemic change in how women's cardiac health is addressed.

Shefali was a star admired for her on-screen presence. Her untimely passing should be a symbol of awareness. Her legacy will remind us that the heart’s silence can be fatal, and that women's cardiac health demands immediate attention, investment, and action.