This presentation highlights significant sex-based differences in valvular heart disease (VHD), impacting diagnosis, management, and outcomes. Women experience higher mortality rates across various VHD types, often present with more advanced disease at diagnosis, and have distinct physiological responses to VHD. For example, women with aortic stenosis have lower calcium scores but experience more rapid disease progression and higher mortality, while their left ventricular response differs significantly from men's. In mitral regurgitation, women present later with more severe disease and higher mortality after surgery, potentially linked to differences in valve morphology and left ventricular remodeling patterns. Tricuspid regurgitation shows sex-related variations in etiology, prevalence, and response to treatment.

These sex differences underscore the need for sex-specific diagnostic criteria and treatment strategies. Current guidelines may not adequately address the unique needs of women with VHD, leading to undertreatment and worse outcomes. Future research should focus on identifying underlying mechanisms driving these sex-based disparities and developing tailored approaches to improve the care and outcomes of women with VHD. Further research is needed, particularly in clinical trials to address the underrepresentation of women in studies.