The European Heart Journal consensus statement, an expert-opinion synthesis rather than an RCT or large observational cohort, correctly flags delayed diagnoses and unique female-specific risks such as preeclampsia and autoimmune-linked disease, yet understates how these gaps stem from decades of trial exclusion of women until the 1993 NIH Revitalization Act. A 2019 meta-analysis in Circulation (observational, n=2.3 million across 30 studies, no major industry conflicts declared) quantified that women receive 15-20% fewer guideline-directed therapies post-MI even after symptom adjustment, a pattern persisting in European registries. The Canadian women's heart center data cited (observational follow-up, ~300 patients) achieved 70% diagnostic yield for MINOCA and INOCA cases but lacked randomization, limiting causal claims about reduced admissions. Broader patterns reveal curriculum inertia: most cardiology training still allocates under 5 hours to sex-specific pathophysiology, perpetuating the very misrecognition the hubs aim to fix. Without mandatory integration of these modules and continuous outcome auditing tied to funding, centers risk becoming elite referral silos rather than systemic correctives.