UAB Division of Cardiothoracic Surgery Assistant Professor Sasha Still, M.D., joined UAB MedCast to discuss how aortic disease presents itself in women and potential avenues for treatment specialization.

While aortic disease affects both men and women, Still explains that women often present later, exhibit more severe disease at diagnosis, and experience higher rates of complications and mortality. These differences are partly due to delayed recognition, biological differences in aortic remodeling, and hormonal changes after menopause.

“Aortic disease is multifactorial, and while men and women are affected similarly, women tend to be diagnosed later and may have more aggressive pathology at presentation,” says Still.

Still emphasizes that while current aortic surgery guidelines do not distinguish between men and women, there is growing recognition of the need for greater vigilance and individualized care for both male and female patients. She highlights that women with aortic disease often require a multidisciplinary approach, involving surgeons, cardiologists, and primary care providers to optimize prevention, surveillance, and surgical decision-making.

“We need to be mindful of the higher risk in women and ensure early diagnosis, close monitoring, and collaboration across specialties to improve outcomes,” says Still.

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