Shefali Jariwala's Death Spotlights Rising Heart Risks for Women: Experts Urge Proactive Screening

The recent passing of Indian television star Shefali Jariwala has raised serious concerns about the increasing incidence of sudden cardiac issues among women. While the official cause of death is pending further investigation, initial reports suggest cardiac arrest, a growing problem impacting seemingly healthy, middle-aged women.

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 India, with nearly 10% attributed to SCD. A significant number of these deaths occur in individuals between 30 and 50 years old.

India's evolving socioeconomic landscape, marked by sedentary lifestyles, processed food consumption, tobacco use, and elevated stress levels, has contributed 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, frequently go undetected until post-mortem examinations. Furthermore, many women don't exhibit typical warning signs like chest pain or ECG anomalies, making early detection difficult.

The Silent Threat to Women in Midlife

Women in their 40s and 50s face a significant risk from underlying cardiac conditions. In younger individuals, SCD is often linked to inherited or electrical disorders like 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, factors such as 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, especially during perimenopause. Additionally, conditions like Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), more prevalent in younger women, often leave no trace in autopsies, complicating diagnosis.

Stress played a significant role in Shefali's life. Takutsobo cardiomyopathy (Broken Heart Syndrome) or Stress-induced Cardiomyopathy is a major cause of SCD in women who multitask and experience emotional stress. Shefali also faced personal struggles due to her divorce, coupled with anxiety, depression, and epilepsy – all potentially impacting cardiovascular health. Psychiatric medications, especially those prolonging the QT interval, have also been linked to an increased risk of SCD.

A Call for Gender-Specific Prevention and Awareness

Women are often underrepresented in preventive heart care, despite the severity of the issue. Symptoms like fatigue, palpitations, or breathlessness are often dismissed or misattributed, delaying crucial intervention. Cardiac arrest, unlike heart attacks caused by blocked arteries, results from electrical disturbances causing the heart to stop suddenly. Immediate CPR and defibrillation are often the only life-saving measures, emphasizing the need for early risk identification.

Medical experts advocate for targeted public health strategies. Enhancing early screening tools tailored to women, particularly during perimenopause when cardiac risks increase, is crucial.

Honoring a Star, Fueling a Movement

The tragic passing of Shefali Jariwala serves as a rallying cry, highlighting an overlooked health crisis and the urgent need for systemic change in addressing women's heart health.

Shefali captivated audiences with her screen presence. In the wake of her untimely death, 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.