Rising Cardiac Arrests in Women: Shefali Jariwala's Death Spotlights Silent Heart Risks

The recent and sudden passing of Indian television actress Shefali Jariwala has sparked widespread concern and discussion. While the official cause of death is pending further investigation, initial reports suggest cardiac arrest. This incident highlights a disturbing trend of seemingly healthy, middle-aged women experiencing sudden heart issues.

The Understudied Crisis of Sudden Cardiac Death

Sudden cardiac death (SCD), once considered rare in young adults, is now increasingly prevalent, 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 aged 30 to 50, raising serious concerns.

India's rapid socioeconomic changes, including increased sedentary lifestyles, consumption of processed foods, tobacco use, and elevated stress levels, are contributing to a surge in hypertension, obesity, diabetes, and coronary artery disease. These are all major risk factors for SCD.

Historically, SCD has been more prevalent among men. However, recent studies emphasize the unique and often overlooked risks faced by women. Unlike men, women who experience SCD often have no prior cardiac diagnoses, making prevention and early detection challenging. Structural abnormalities, such as myocardial scarring and ischemic heart disease, may go undetected until post-mortem examinations. Furthermore, many women do not exhibit the classical warning signs, such as chest pain or ECG anomalies.

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 frequently 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.

Additional factors that increase vulnerability in this age group 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, 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 critical role. 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. Jariwala's personal struggles, including her divorce, anxiety, depression, and epilepsy, likely intersected with her cardiovascular health. Certain psychiatric medications, especially those that prolong the QT interval, have also been linked to an increased risk of SCD.

The Imperative for Gender-Specific Prevention and Awareness

Despite the seriousness of the issue, women are underrepresented in preventive heart care. Symptoms like fatigue, palpitations, or breathlessness are often dismissed or misattributed, leading to delayed 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 life-saving measures, highlighting the critical need for early risk identification.

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

Remembering a Star, Igniting a Movement

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

Shefali Jariwala captivated audiences with her talent. In the wake of her untimely death, she will 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.