Spoilers ahead for And Just Like That…, the Sex and the City reboot on HBO Max, although this news has been hard to ignore whether or not you even watch the show.
Consider yourself warned, because unlike Carrie Bradshaw, I’m diving right into action. Here’s what goes down: Carrie’s husband, John, aka “Big,” has a heart attack. After puffing on a cigar and completing a vigorous Peloton indoor-cycling session, Big collapses near the shower, where Carrie finds him and springs into action. Actually, Carrie finds him and freezes. They stare at each other. He slumps over. She yells out. She rushes to him. She does not call 911. She does not perform CPR. Instead, she tells us via an iconic Carrie Bradshaw voiceover: “And just like that, Big died.”
Now, fans everywhere ranging from dumbfounded to outraged are demanding answers: Is Carrie to blame for watching Big die? What should someone actually do in that situation in real life? Is my Peloton going to be my demise? (Probably not.)
First things first: If you’re reading this because you think you or someone else is having a heart attack, call 911 now. Don’t be a Carrie. Be a hero. Here’s what else you need to know to recognize the symptoms of a heart attack, and what you should do if they occur.
How to recognize symptoms of a heart attack
Some heart attacks strike suddenly, but many people have warning signs hours or days in advance. According to Mayo Clinic, someone having a heart attack may have any or all of the following:
- Chest pain, pressure or tightness, or a squeezing or aching sensation in the center of the chest
- Pain or discomfort that spreads to the shoulder, arm, back, neck, jaw, teeth or occasionally upper abdomen
- Nausea, indigestion, heartburn, or abdominal pain
- Shortness of breath
- Lightheadedness, dizziness, fainting
A heart attack generally causes chest pain for more than 15 minutes, although some people have no chest pain or pressure at all. This discomfort can persist, or it can last for a couple minutes, go away, then come back. Women, for instance, tend to have more-vague symptoms, such as nausea or back or jaw pain.
Why time is of the essence (looking at you, Carrie)
In the words of CPR-certified Lifehacker Senior Health Editor Beth Skwarecki: “watching someone die is not in fact good first aid.” While Carrie’s shock is understandable, Big’s death might have been avoidable.
According to the Red Cross, seeking advanced medical care as soon as the signs and symptoms of a heart attack are recognized can minimize damage to the heart and may save the person’s life. Evidence suggests that a heart attack victim’s outcomes are significantly improved if they get help within 90 minutes of the onset of signs and symptoms and within 60 minutes of arrival to the hospital.
So, for And Just Like That… fans: Rachel Handler investigated the facts of the Big heart attack in Vulture. Handler found that Big would have been experiencing a heart attack for about 30 minutes when Carrie found him, meaning Carrie would have had time to act. So what should she have done?
What to do when someone is having a heart attack
For more information, please see the Red Cross guidelines here.
Again, we want to be clear here: the first thing you should do is to call 911 or your local emergency number. Don’t ignore the symptoms. If you’re the one experiencing heart attack symptoms and you can’t get an ambulance or emergency vehicle to come to you, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only if you have no other option; since your condition can worsen, driving yourself puts you and others at risk.
Secondly, be prepared to give CPR if someone else is experiencing symptoms and becomes unresponsive and stops breathing normally. If the person isn’t breathing or you don’t find a pulse, begin CPR to keep blood flowing after you call for emergency medical help. Push hard and fast on the center of the person’s chest in a fairly rapid rhythm—about 100 to 120 compressions a minute.
Even if you don’t know how to find a pulse or aren’t CPR trained, you can still call 911 and push on the person’s chest, as per these guidelines.
In the meantime, here’s what else you can do:
- Chew and swallow an aspirin while waiting for emergency help. Aspirin helps keep your blood from clotting. When taken during a heart attack, it could reduce heart damage.
- Take nitroglycerin, if prescribed (which Big is). (Or, Big was.) (RIP, Big.) If you think you’re having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed while waiting for emergency medical help.
- If an automated external defibrillator (AED) is immediately available and the person is unconscious, follow the device instructions for using it.
- Help the person to rest in a comfortable position, and loosen any tight clothing. Many people find it easier to breathe when sitting.
- Reassure the person and monitor their condition until EMS personnel arrive and take over.
So, could Carrie have saved Big?
Theoretically, yes. Daniel Luger, a cardiologist at Chicago’s Rush University Medical Center, tells Vulture:
What [Carrie] needed to do was, when he went unconscious and lost a pulse, she needed to immediately start CPR. Feel for a pulse, call for help, and start chest compressions. Because you can absolutely stimulate blood flow to the brain and the rest of the vital organs with CPR, and once EMS came, they could have resuscitated him immediately with medications and defibrillation…This is a PSA: If you see somebody lose consciousness, the first thing you do is feel for a pulse. If there’s no pulse, you call EMS and start chest compressions without delay. You can definitely save people’s lives that way. He didn’t need to die. This is a goddamn travesty.
A goddamn travesty indeed. And guess what? I don’t even watch the show.
Here’s our past coverage on what to do if you think you’re having a heart attack, and why it’s never worth any kind of waiting game.