Sudden Cardiac Arrests on the Rise Among Women: Shefali Jariwala's Death Sparks Urgent Health Concerns

The unexpected passing of Indian actress Shefali Jariwala has sparked widespread concern and highlighted a critical issue: the rising incidence of sudden cardiac events in seemingly healthy, middle-aged women. While the official cause of Jariwala's death is pending further investigation, initial reports suggest a cardiac arrest. This incident underscores a growing trend demanding greater attention and research.

The Rise of Sudden Cardiac Death

Sudden cardiac death (SCD), once considered rare in young adults, is becoming 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 affects individuals between 30 and 50 years old.

India's evolving socioeconomic landscape has contributed to lifestyle changes such as:

• Sedentary behavior
• Processed diets
• Increased tobacco use
• Elevated stress levels

These factors contribute to a surge in 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 women face. 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. Furthermore, many women do not exhibit classic 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 significant risk from underlying cardiac conditions. In younger populations, SCD 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. Additional risk factors in this age group include left ventricular hypertrophy, obesity, and myocardial fibrosis.

The progression of myocardial scarring and fibrosis 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), which are 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's personal struggles, including divorce, anxiety, depression, and epilepsy, may have intersected with her cardiovascular health. Psychiatric medications, particularly those that prolong the QT interval, have also been linked to an increased SCD risk.

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

Jariwala captivated audiences with her on-screen presence. Her untimely demise serves as a stark reminder that the heart’s silence can be fatal and that women's cardiac health demands immediate attention, investment, and action.