Sudden Cardiac Deaths in Women: Shefali Jariwala's Passing Highlights a Growing Crisis

The recent, unexpected death of Indian actress Shefali Jariwala has sparked widespread concern and brought attention to a disturbing trend: the increasing incidence of sudden cardiac events in seemingly healthy, middle-aged women. While the official cause of Jariwala's death awaits confirmation, preliminary reports suggest a cardiac arrest.

The Growing Crisis of Sudden Cardiac Death

Sudden Cardiac Death (SCD), once considered rare in young adults, is now occurring with increasing frequency, 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.

India's socioeconomic transformation has led to lifestyle changes that contribute to this rise, including:

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

These factors fuel a surge in conditions like hypertension, obesity, diabetes, and coronary artery disease, all of which increase the risk of SCD.

While historically more prevalent 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, often go undetected until post-mortem examinations. Many women also do not exhibit classical warning signs like chest pain or ECG anomalies, making early detection extremely difficult.

The Silent Threat to Women in Midlife

Women in their 40s and 50s, like Shefali Jariwala, face a silent but serious risk from underlying cardiac conditions. In younger populations, SCD is frequently associated with inherited or electrical disorders such as:

• Hypertrophic Cardiomyopathy
• Arrhythmogenic Right Ventricular Cardiomyopathy
• Long QT Syndrome
• Brugada Syndrome
• Catecholaminergic Polymorphic Ventricular Tachycardia

These conditions often show no symptoms 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, especially during perimenopause. Furthermore, conditions like Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), more prevalent in younger women, often leave no trace in autopsies, making diagnosis even more elusive.

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, including divorce, 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 to Action: Gender-Specific Prevention and 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 now urging for more targeted public health strategies, including enhanced early screening tools tailored to women, particularly during perimenopause when cardiac risks surge.

Honoring a Life, Fueling a Movement

The tragic passing of Shefali Jariwala serves as a rallying cry. Her death highlights an overlooked health crisis and the urgent need for systemic change in how women's heart health is addressed.

Jariwala captivated audiences with her screen presence. In the wake of her untimely demise, she may well 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.