Shefali Jariwala's Death Highlights Rising Heart Concerns Among Women: Experts Urge Increased Awareness and Screening

The unexpected death of Indian actress Shefali Jariwala has prompted widespread concern. While the official cause is pending further investigation, initial reports point to cardiac arrest, highlighting a disturbing trend affecting seemingly healthy, middle-aged women.

An Increasingly Common, Yet Understudied Crisis

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 number of these deaths occur in individuals between 30 and 50 years old.

India's rapid socioeconomic changes have led to lifestyle shifts, including sedentary behavior, processed foods, 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.

While historically more common in men, recent studies emphasize the unique risks faced by women, which are often overlooked. 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 incredibly challenging.

The Silent Threat in Middle-Aged Women

Women in their 40s and 50s face a silent, but 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, and Catecholaminergic Polymorphic Ventricular Tachycardia. These conditions may remain asymptomatic 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. 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 also played a role in Jariwala's life, who began her career as a teen star. Takutsobo cardiomyopathy (Broken Heart Syndrome) or Stress-induced Cardiomyopathy is a significant 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 associated with an increased risk of SCD.

A Call for Gender-Specific Prevention and Awareness

Despite the severity of the issue, women are underrepresented in preventive heart care. Symptoms such as fatigue, palpitations, or breathlessness are often dismissed or misattributed, delaying critical 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, emphasizing the need for early risk identification.

Medical experts are urging for more targeted public health strategies, including enhanced early screening tools tailored to women, especially during perimenopause when cardiac risks surge.

Honoring a Star, Fueling a Movement

As the entertainment industry and fans mourn the loss of Shefali Jariwala, her tragic death serves as a rallying cry. Her passing shines a light on 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 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.

Dr. Sarita Rao, MD, DM, FACC, FSCAI, Senior Interventional Cardiologist & Director Cathlab, Apollo Hospitals, Indore; President, WINCARS Association, Co-chair, EAPCI International Affairs, SCAI International Board member, WIN-APSIC Board member