Headline: Actress Shefali Jariwala's Death Highlights Rising Risk of Sudden Cardiac Arrest in Women: Experts Urge Awareness, Gender-Specific Screening

The recent and unexpected death of Indian television actress Shefali Jariwala has sparked widespread concern and highlighted a growing issue: the increasing number of sudden cardiac deaths (SCD) among seemingly healthy, middle-aged women. While the official cause of Jariwala's death is pending post-mortem and forensic analysis, preliminary reports suggest a cardiac arrest.

The Underestimated Crisis of Sudden Cardiac Death

Sudden cardiac death, once considered a rare occurrence in young adults, is now increasingly prevalent, particularly in India. This alarming trend has captured the urgent attention of the medical community. Cardiovascular diseases currently account for approximately 28% of all deaths in India, with nearly 10% attributed to SCD. A significant portion of these fatalities affects individuals between 30 and 50 years old.

India's rapid socioeconomic changes have led to lifestyle shifts, including:

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

These factors contribute to a surge in conditions like hypertension, obesity, diabetes, and coronary artery disease, all major risk factors for SCD.

While historically more common in men, 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. Adding to the challenge, many women do not exhibit classic warning signs like chest pain or ECG anomalies, making early detection exceedingly difficult.

Midlife Women: A Silent Threat

Women in their 40s and 50s, like Shefali Jariwala, face a silent yet serious 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 present no symptoms until a fatal arrhythmia occurs.

In this age group, additional factors like left ventricular hypertrophy, obesity, and myocardial fibrosis can 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, particularly during perimenopause. Moreover, 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 was a significant factor in Shefali's life, beginning with her early career as a teen star. Takutsobo cardiomyopathy (Broken Heart Syndrome) or stress-induced cardiomyopathy is a major cause of SCD in women who juggle multiple responsibilities and experience emotional stress. Shefali also faced personal challenges, 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.

Urgent Call for Gender-Specific Prevention and Awareness

Despite the seriousness of the issue, women remain underrepresented in preventive heart care. Symptoms such as fatigue, palpitations, or breathlessness are often dismissed or misattributed, leading to delays in 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 advocating for more targeted public health strategies, including enhanced early screening tools specifically tailored for women, particularly during perimenopause when cardiac risks are heightened.

Remembering a Star, Inspiring Action

The entertainment industry and fans mourn the loss of Shefali Jariwala. Her tragic passing serves as a poignant reminder of an overlooked health crisis and the urgent need for systemic change in how women's heart health is addressed.

Shefali Jariwala captivated audiences with her on-screen presence. In the wake of her untimely death, she may be remembered as a symbol of awareness, highlighting that the heart’s silence can be fatal and that women's cardiac health demands immediate attention, investment, and action.