Valvular Heart Disease in Women

Valvular heart disease (VHD) is a major cause of cardiovascular mortality and morbidity worldwide in both women and men, despite medical and interventional management improvements over the past two decades. The pathophysiology of VHD is similar in women compared to men, but there are some important differences in clinical presentation and management as summarized in this chapter. In women with VHD who become pregnant, the hemodynamic changes of pregnancy may precipitate symptoms or lead to hemodynamic decompensation. Management during pregnancy of women with known VHD or a prosthetic valve can be challenging. Outcomes after surgical or transcatheter intervention are not always the same in women compared to men. Although women historically have been underrepresented in cardiovascular clinical trials, recent clinical trials of new interventions for VHD have an appropriate sex balance.