Shefali Jariwala's Death Spotlights Rising Cardiac Arrest Risk Among Women: Experts Urge Awareness and Targeted Prevention

The unexpected passing of Indian actress Shefali Jariwala has raised serious questions about women's heart health. While the official cause of death is pending further investigation, initial reports suggest cardiac arrest, highlighting a worrying trend of sudden heart issues in seemingly healthy, middle-aged women.

The Rise of Sudden Cardiac Death

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

India's evolving socioeconomic landscape has brought about lifestyle changes, including:

• Sedentary behavior
• Processed diets
• Tobacco use
• Increased stress levels

These factors contribute to a rise in:

• Hypertension
• Obesity
• Diabetes
• Coronary artery disease

All of which are significant risk factors for SCD.

While historically more common in 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, may go undetected until post-mortem examinations. Furthermore, many women do not exhibit typical warning signs like chest pain or ECG anomalies, making early detection challenging.

The Silent Threat to Women in Midlife

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

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

These conditions may remain asymptomatic until a fatal arrhythmia occurs.

In this age group, additional factors such as:

• Left ventricular hypertrophy
• Obesity
• Myocardial fibrosis

Increase vulnerability. The progression of myocardial scarring and fibrosis with age can be attributed to cumulative exposure to cardiovascular risks, repeated micro-ischemic events, and hormonal changes, especially during perimenopause. Conditions like Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), more prevalent in younger women, often leave no trace in autopsies, complicating diagnosis.

Stress was a significant factor in Shefali Jariwala's life. Takutsobo cardiomyopathy (Broken Heart Syndrome) or stress-induced Cardiomyopathy is also a major cause of SCD in women who multitask and are emotionally stressed. Shefali also faced personal struggles due to her divorce, along with anxiety, depression, and epilepsy, all of which can intersect with cardiovascular health. Psychiatric medications, particularly those that prolong the QT interval, have also been linked to an increased risk of SCD.

A Call for Gender-Specific Prevention and Awareness

Despite the seriousness of the issue, women remain underrepresented in preventive heart care. Symptoms like fatigue, palpitations, or breathlessness are often dismissed or misattributed, delaying necessary intervention. Unlike heart attacks, which 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 need for early risk identification.

Medical experts are now advocating for more targeted public health strategies. There's a need to enhance early screening tools tailored to women, especially during perimenopause when cardiac risks increase.

Honoring a Star, Fueling a Movement

As the entertainment industry and fans mourn the loss of Shefali Jariwala, her tragic death serves as a catalyst for change. Her passing highlights an overlooked health crisis and the urgent need for systemic improvements in addressing women's heart health.

Shefali Jariwala, captivated audiences with her talent. Beyond her on-screen presence, she will now be remembered as a symbol of awareness, a reminder that the heart’s silence can be fatal, and that women's cardiac health demands immediate attention, investment, and action.