Shefali Jariwala's Death Spotlights Silent Heart Threat to Women: Experts Urge Action on Overlooked Risks

The sudden death of Indian television star Shefali Jariwala has sparked widespread concern and highlighted a troubling trend: the increasing incidence of sudden cardiac arrest in seemingly healthy, middle-aged women. While the official cause of Jariwala's death is pending a post-mortem examination and forensic analysis, preliminary reports point to cardiac arrest, raising critical questions about women's heart health and the factors contributing to this phenomenon.

An Overlooked Crisis

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 occurs in individuals aged 30 to 50.

India's rapid socioeconomic changes have led to lifestyle shifts, including sedentary behavior, processed food consumption, tobacco use, and increased stress levels. These factors contribute to a rise in hypertension, obesity, diabetes, and coronary artery disease – 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 frequently have no prior cardiac diagnoses. Structural abnormalities, such as myocardial scarring and ischemic heart disease, often remain undetected until post-mortem examinations. Furthermore, many women do not exhibit classic warning signs like chest pain or ECG anomalies, making early detection incredibly difficult.

The Silent Threat to Women in Their 40s and 50s

Women in their 40s and 50s face a silent yet serious 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.

In this age group, factors like left ventricular hypertrophy, obesity, and myocardial fibrosis increase vulnerability. The progression of myocardial scarring and fibrosis can be attributed to cumulative exposure to cardiovascular risks, repeated micro-ischemic events, and hormonal changes, especially during perimenopause.

Conditions like Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), more prevalent in younger women, often leave no trace in autopsies, further 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 her 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 risk of SCD.

A Call for Prevention and Awareness Tailored to Women

Despite the severity of the issue, women are underrepresented in preventive heart care. Symptoms like fatigue, palpitations, or breathlessness are often dismissed or misattributed, delaying crucial 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 lifesaving measures, highlighting the critical need for early risk identification.

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

Remembering Shefali Jariwala, Inspiring Action

The tragic passing of Shefali Jariwala serves as a powerful reminder of the urgent need for systemic change in how women's heart health is addressed. While she will be remembered for her captivating screen presence, her untimely death should also serve as a catalyst for awareness. It underscores the fact that heart issues can be silent and fatal, and that women's cardiac health demands immediate attention, investment, and proactive measures.