Aortic mural thrombus in young women: premature arteriosclerosis or separate clinical entity?

Two young women were admitted with peripheral arterial emboli secondary to aortic mural thrombi, and each underwent successful aortic thromboendarterectomy procedures. Both patients were taking oral steroidal medications, and both patients were heavy cigarette smokers. These cases and a careful review of the previous literature suggest that the development of aortic mural thrombi in young women may not always represent premature arteriosclerosis, as has been previously presumed, but may represent a separate and distinct clinical entity, at least in some patients.