Shefali Jariwala's Sudden Death Spotlights Rising Heart Risks for Women: Experts Urge Awareness and Prevention

The unexpected death of Indian television star Shefali Jariwala has raised serious questions about women's heart health. While the official cause of death is pending a post-mortem and forensic analysis, initial reports suggest cardiac arrest, a growing concern among seemingly healthy, middle-aged women.

The Rise of Sudden Cardiac Death

Sudden cardiac death (SCD) was once considered rare in young adults. However, its increasing prevalence, particularly in India, demands attention. Cardiovascular diseases account for approximately 28% of all deaths in India, with nearly 10% linked to SCD. A significant portion of these fatalities occur in individuals aged 30 to 50.

India's socioeconomic transformation has led to lifestyle changes like sedentary behavior, processed diets, tobacco use, and rising stress levels, contributing to hypertension, obesity, diabetes, and coronary artery disease – all major 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. Many women also don't exhibit classical 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 like Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy, Long QT Syndrome, Brugada Syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia. These conditions may remain asymptomatic until a fatal arrhythmia occurs.

Additional factors such as left ventricular hypertrophy, obesity, and myocardial fibrosis increase vulnerability in this age group. 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 also plays a significant role. 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 struggles related 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 Awareness and Prevention

Women remain underrepresented in preventive heart care, despite the severity of the issue. 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, emphasizing the need for early risk identification.

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

Honoring a Life, Fueling a Movement

The entertainment industry and fans mourn the loss of Shefali Jariwala, and her tragic passing serves as a rallying cry. Her death highlights a neglected health crisis and the urgent need for systemic change in how women's heart health is addressed.

Jariwala captivated audiences with her screen presence. Now, she may 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.