​Shefali Jariwala's death sparks concern: Why are more women dying suddenly of heart issues?

Time of India

21 hours ago

The sudden demise of Indian television personality and actress Shefali Jariwala has sent shockwaves across the nation. While the official cause of death awaits confirmation pending a post-mortem and forensic analysis, preliminary reports suggest a cardiac arrest, a growing and concerning phenomenon affecting seemingly healthy, middle-aged women.
A growing, understudied crisis:
Sudden cardiac death or SCD has long been considered a rare event among young adults. However, its rising prevalence, particularly in India, is drawing critical attention from the medical community. Cardiovascular diseases currently account for approximately 28% of all deaths in the country, with nearly 10% of these linked to sudden cardiac death. Alarmingly, a significant proportion of these fatalities occur in individuals aged 30 to 50.
India's ongoing socioeconomic transformation has introduced widespread lifestyle changes sedentary behavior, processed diets, tobacco use, and rising stress levels fueling a surge in hypertension, obesity, diabetes, and coronary artery disease, all key contributors to SCD.
While historically more prevalent among men, recent studies underscore 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 go undetected during life, only being identified in post-mortem examinations. Even more concerning is that many women do not exhibit classical warning signs such as chest pain or ECG anomalies, making early detection a formidable challenge.
The silent threat in midlife women
Women in their 40s and 50s like Shefali face a silent but serious risk from underlying cardiac conditions.
In younger populations, SCD is frequently associated with inherited or electrical disorders such as Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy, Long QT Syndrome, Brugada Syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia. These conditions often show no symptoms 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, particularly during the perimenopausal years. Moreover, conditions like Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), more prevalent in younger women—often leave no trace in autopsies, making diagnosis even more elusive.
Stress formed a major part of Shefali's journey, who started as a teen star. Takutsobo cardiomyopathy (Broken Heart Syndrome) or Stress induced Cardiomyopathy is also a major cause of SCD in women who multitask and emotionally stressed. Shefali also had her personal struggles due to her divorce, with anxiety, depression and epilepsy—both of which may intersect with cardiovascular health. Psychiatric medications, particularly those that prolong the QT interval, have also been linked to heightened SCD risk.
A call for gender-specific prevention and awareness
Despite the gravity of the issue, women remain underrepresented in preventive heart care. Symptoms such as fatigue, palpitations, or breathlessness are often dismissed or misattributed, delaying crucial intervention. In contrast to heart attacks—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.
As medical experts we are now urging for more targeted public health strategies. We need to enhance early screening tools tailored to women, particularly 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 passing serves as more than a moment of grief—it is a rallying cry. Her death shines a spotlight on an overlooked health crisis and the urgent need for systemic change in how women's heart health is addressed.
Shefali was a star who captivated audiences with her screen presence. But in the wake of her untimely demise, she may well 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