Sudden Cardiac Death in Women: Shefali Jariwala's Death Highlights Growing Crisis

The sudden passing of Indian actress Shefali Jariwala has sparked widespread concern, highlighting a troubling trend: the increasing incidence of sudden cardiac death (SCD) among women. While the official cause of Jariwala's death is pending further investigation, initial reports suggest a cardiac arrest, raising questions about why more seemingly healthy, middle-aged women are succumbing to heart-related issues.

Understanding the Growing Crisis of Sudden Cardiac Death

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

India's rapid socioeconomic changes have contributed to this rise, with sedentary lifestyles, processed diets, tobacco use, and increasing stress levels leading to a surge in hypertension, obesity, diabetes, and coronary artery disease – all major risk factors for SCD.

While historically more prevalent in men, recent studies emphasize the unique risks women face. Unlike men, women experiencing SCD often have no prior cardiac diagnoses. Structural abnormalities, such as myocardial scarring and ischemic heart disease, frequently go undetected until post-mortem examinations. Adding to the complexity, many women don't exhibit classic warning signs like chest pain or ECG anomalies, making early detection incredibly difficult.

The Silent Threat to Women in Midlife

Women in their 40s and 50s face a silent yet serious risk from underlying cardiac conditions. In younger populations, SCD is often linked to inherited or electrical disorders like Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy, Long QT Syndrome, Brugada Syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia. These conditions often remain asymptomatic until a fatal arrhythmia occurs.

In this age group, additional factors like left ventricular hypertrophy, obesity, and myocardial fibrosis increase vulnerability. Myocardial scarring and fibrosis can be attributed to cumulative exposure to cardiovascular risks, repeated micro-ischemic events, and hormonal changes, particularly during perimenopause. Moreover, conditions such as Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), which are more prevalent in younger women, often leave no trace in autopsies, further complicating diagnosis.

Stress is also a significant factor. Takutsobo cardiomyopathy (Broken Heart Syndrome), or stress-induced cardiomyopathy, is a major cause of SCD in women who multitask and experience high levels of emotional stress. In Shefali Jariwala's case, personal struggles related to divorce, anxiety, depression, and epilepsy may have intersected with her 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 Greater Awareness

Despite the severity of the issue, women remain underrepresented in preventive heart care. Symptoms such as fatigue, palpitations, or breathlessness are often dismissed or misattributed, leading to delays in 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 need for early risk identification.

Medical experts are urging for more targeted public health strategies to enhance early screening tools tailored to women, particularly during perimenopause when cardiac risks surge.

Remembering a Star, Inspiring Action

The entertainment industry and fans mourn the loss of Shefali Jariwala. Her tragic passing serves as a reminder of the urgent need for systemic change in how women's heart health is addressed.

Shefali Jariwala, remembered for her captivating screen presence, may also be remembered as a symbol of awareness, highlighting that the heart's silence can be fatal and that women's cardiac health demands immediate attention, investment, and action.