Shefali Jariwala's Death Focuses Attention on Rising Sudden Cardiac Arrest Rates in Women

The recent, unexpected death of Indian actress Shefali Jariwala has sparked widespread concern and brought attention to a worrying trend: the increasing incidence of sudden cardiac arrest (SCA) in women. While the official cause of Jariwala's death is pending further investigation, initial reports suggest a cardiac event, highlighting a critical health issue often overlooked.

The Growing Crisis of Sudden Cardiac Death

Sudden cardiac death, once considered rare among young adults, is now occurring with increasing frequency, particularly in India. Cardiovascular diseases are responsible for approximately 28% of all deaths in India, with nearly 10% of these attributed to SCA. A significant number of these fatalities occur in individuals between 30 and 50 years old.

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

• Sedentary behavior
• Unhealthy diets
• Tobacco use
• Elevated stress levels

These factors contribute to a rise in hypertension, obesity, diabetes, and coronary artery disease, all major risk factors for SCA.

While historically more prevalent in men, recent studies emphasize the unique and often underestimated risks faced by women. Unlike men, women experiencing SCA often have no prior diagnosis of cardiac issues. Structural abnormalities, such as myocardial scarring and ischemic heart disease, may go undetected until post-mortem examinations. Furthermore, many women do not exhibit classic warning signs like chest pain or ECG abnormalities, making early detection difficult.

The Silent Threat to Women in Midlife

Women in their 40s and 50s, like Shefali Jariwala, face a significant risk from underlying cardiac conditions. In younger populations, SCA 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 factors such as left ventricular hypertrophy, obesity, and 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, particularly 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 played a significant role in Shefali Jariwala's life. Takutsobo cardiomyopathy (Broken Heart Syndrome), or stress-induced cardiomyopathy, is a major cause of SCA 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 SCA.

A Call for Gender-Specific Prevention and Increased Awareness

Despite the severity of the issue, women remain underrepresented in preventive heart care. Symptoms like fatigue, palpitations, or breathlessness are often dismissed or misattributed, delaying crucial 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, underscoring the need for early risk identification.

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

Honoring a Star, Fueling a Movement

The entertainment industry and fans mourn the loss of Shefali Jariwala, her tragic passing serves as more than a moment of grief—it is a rallying cry. Her death shines a spotlight on an overlooked health crisis and the urgent need for systemic change in how women's heart health is addressed.

Shefali Jariwala will be remembered not only for her captivating screen presence but also 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.