It depends on the circumstances; if it's when he first lays eyes on a girl before a date, it means he's impressed, if it's during an argument, it means he can't believe what he's hearing or involved in, if it's when she's just told him she's leaving for a 2 week vacation with her girlfriends to Cancun, it means he's devastated.
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When a girl says "wow" to you, it could indicate that she is impressed, surprised, or intrigued by something you said or did. It's a positive reaction that shows she has taken notice of you in a favorable way.
That you have said something embarrassing or done something stupid. Sorry to break it to you----they could b angry too, like, saying : "Wow." in an upset tone. Not good anyway around.