And Just Like That: Cardiac Nurse weighs in on big twist

Sarah Jessica Parker attends premiere of 'And Just Like That'

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Fans of Sex And The City were devastated by the plot twist at the end of the first episode of And Just Like That, the long-anticipated sequel. While some SATC devotees were balling their eyes out, others questioned how realistic the killing-off of a major character was. Final warning: this article contains spoilers for episode one of And Just Like That.

It’s been a long 17-year wait since Carrie, Miranda and Charlotte last appeared on our TV screens; the glamorous threesome, now without their raucous pal Samantha, are now in their fifties and giving middle-age a very chic makeover in New York City.

While viewers might have been expecting a return of fabulous fashion, footwear and flirting, they were shocked by the heartbreaking death of Carrie’s husband Mr Big.

However, Carrie’s response to her husband’s cardiac emergency had viewers divided.

Even Piers Morgan waded into the debate, tweeting: “If you’re a middle-aged man watching the first episode of revived Sex in the City with your wife/girlfriend and she doesn’t immediately scream ‘Why isn’t Carrie calling emergency services?’ as she leisurely cuddles Mr Big’s STILL ALIVE body… dump her asap.”

Chloe MacArthur, senior cardiac nurse at the British Heart Foundation, joined exclusively to weigh in on Mr Big’s fate, and what you should do in the event of a suspected heart attack.

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First, let’s recap what happened in the first episode of And Just Like That…

In true 2021 style, Mr Big spends the episode praising his Peloton bike, although he confesses to still enjoying a weekly cigar.

At the end of the episode, Carrie leaves Big in their luxurious Fifth Avenue apartment for the evening, where he plans to spend the evening exercising on his Peloton bike.

However, after some tough climbs at the end of his 1000th ride, Big clutches his left arm and falls to the floor with chest pains.

SATC fans watched in horror as Carrie returns home to find the love of her life slumped over in their bathroom, she lets out an agonising wail, and runs to Mr Big, who dies in her arms.

So far, so heart-wrenching. But more cynical viewers had questions: Why doesn’t Carrie call the emergency services? And can riding an exercise bike really cause a heart attack?

Let’s ask the expert.

Does riding an exercise bike increase your risk of heart attack?

Chloe MacArthur said: “Staying active is good for our hearts. But it’s important to know your limits and not to push too hard, especially if you are living with a heart condition.

“Overdoing it during exercise can put extra strain on the heart. This can lead to increased heart symptoms and potentially, a transient increased risk of a cardiac event like a heart attack.

“If someone is worried about how much exercise they should be doing, their doctor or nurse should be able to give them more information about their limits.”

As the show tells us Mr Big was a frequent exerciser, it’s possible his active lifestyle actually prevented a cardiac event from happening sooner, despite how his heart attack took place.

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Why was Mr Big clutching his shoulder?

The symptoms of a heart attack can vary, and the chest isn’t always the first place you might feel pain.

We see Mr Big hold his shoulder and arm in pain before he clutches his chest, making his fate more obvious to the viewer.

Chloe said: “Heart attack symptoms can vary from person to person, but the most common signs of a heart attack are chest pain or discomfort that suddenly occurs and doesn’t go away. It may feel like pressure, squeezing or heaviness in your chest. It can feel like indigestion or a burning sensation pain that may spread to your left or right arm or may spread to your neck, jaw, back or stomach feeling sick, sweaty, light-headed or short of breath.”

Chloe said: “The first thing you must do is dial 999 immediately for an ambulance.

“Don’t worry if you’re not completely sure whether your symptoms are a heart attack. It’s really important you seek medical attention regardless as quickly as possible.”

Which brings us on to the burning question…

Could Carrie have saved Mr Big’s life?

To be fair to Carrie, she was in shock at the sight of her husband fighting for his life.

But viewers immediately criticised her response, noting she moved Big from being sat propped against the wall, and, critically, not calling an ambulance straight away.

Chloe said: “There is no way to know for certain if Mr Big would have survived had Carrie responded differently.

“What we do know is time is of the essence when someone is having a heart attack. By calling an ambulance as soon as possible, you are giving that person their best chance of survival and of maintaining a good quality of life.”

Sitting down is recommended after someone has a heart attack, because this eases the strain on the heart and aids circulation, so Carrie moving Big to the floor may not have helped but probably wouldn’t have been a fatal mistake.

If there’s one mistake Carrie made, it wasn’t calling an ambulance straight away.

Chloe said: “A heart attack is a medical emergency. It is vital if you suspect someone is having a heart attack, you call for an ambulance immediately.

“Heart attacks are life-threatening, but treatment can increase someone’s chances of surviving and continuing to live a full life afterwards.”

For more information on heart attacks, advice and symptoms, head to the British Heart Foundation’s website. 

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