SCAD                    Spontaneous Coronary Artery Dissection

 

 

SCAD Survey

SCAD Survey

If you have had a SCAD, please take the time to fill out the survey below.   You may remain anonymous if you wish, but please use at least a nickname.  Thank you.

Today's Date:
Date your SCAD occurred:
Your Name
Your sex  FemaleMale
Email Address (optional)
Your age when SCAD occurred:
Did your SCAD occur during exertion or at rest?  Please describe.
Level of fitness when SCAD occurred?          i.e. very fit, overweight, active, sedentary, etc.
If female, were you on your period, or post partum at the time of your SCAD?  Please state which, and if post-partum, how long after childbirth did it occur.
How would you describe your stress level at the time of your SCAD?
What medications were you on at the time of your SCAD?
Any other major medical issues prior to your SCAD?
Were you on birth control at the time of your SCAD?
Any history of heart disease, cardiac risk factors, or family history of heart disease?
Any history of anemia, auto-immune or connective tissue disorders?
How were you treated for the initial SCAD?    ie. stents, surgery, only medicine
What medicine are you on now?
Have you been tested for any connective tissue disorders since your SCAD?
Describe any strange side effects you have noticed since your SCAD.
How did you find this website?:
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