Sudden Heart Deaths in Women: Shefali Jariwala's Case Fuels Concern Over Overlooked Risks

The unexpected death of Indian actress Shefali Jariwala has raised serious questions about women's heart health, particularly the rising incidence of sudden cardiac death (SCD) among seemingly healthy, middle-aged women. While the official cause of Jariwala's death is pending further investigation, preliminary reports suggest cardiac arrest, highlighting a worrying trend.

The Rise of Sudden Cardiac Death

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

India's rapid socioeconomic changes have contributed to this increase. Sedentary lifestyles, processed foods, tobacco use, and elevated stress levels are driving up rates of hypertension, obesity, diabetes, and coronary artery disease – all major risk factors for SCD.

While historically more common in men, recent studies emphasize the unique risks women face. Unlike men, women who experience SCD often have no prior diagnosis of heart issues. Structural abnormalities, like myocardial scarring and ischemic heart disease, may go undetected until post-mortem examinations. Furthermore, many women don't exhibit typical warning signs like chest pain or ECG abnormalities, making early detection challenging.

The Silent Threat to Women in Midlife

Women in their 40s and 50s, like Shefali Jariwala, face a significant, often silent, 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, factors like left ventricular hypertrophy, obesity, and myocardial fibrosis increase vulnerability. Myocardial scarring and fibrosis can worsen with age due to accumulated exposure to cardiovascular risks, repeated micro-ischemic events, and hormonal changes, especially during perimenopause. Additionally, conditions like Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), more prevalent in younger women, may not be detectable in autopsies, complicating diagnosis.

Stress is also a major factor. Takutsobo cardiomyopathy (Broken Heart Syndrome), or stress-induced cardiomyopathy, is a significant cause of SCD in women who multitask and experience emotional stress. Jariwala's personal struggles, including her divorce, anxiety, depression, and epilepsy, may have also played a role, as these conditions can intersect with cardiovascular health. Psychiatric medications, particularly those that prolong the QT interval, have been linked to increased SCD risk.

A Call for Gender-Specific Prevention

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

Medical experts are now advocating for targeted public health strategies, including enhanced early screening tools specifically designed for women, particularly during perimenopause, when cardiac risks increase.

Honoring a Life, Fueling Awareness

Shefali Jariwala's tragic death serves as a call to action. Her passing highlights an often-overlooked health crisis and the urgent need for systemic change in how women's heart health is addressed.

Jariwala captivated audiences with her on-screen presence. Her untimely demise should serve as a symbol of awareness, reminding us that the heart’s silence can be fatal, and that women's cardiac health demands immediate attention, investment, and action.