Learning of Lamar's (Powers Boothe) heart attack Rayna (Connie Britton) is forced to withdraw from the sold out New York City concert and fly with her daughters (Lennon Stella, Maisy Stella) back home to Nashville. In the hospital with her sister (Judith Hoag) and Watty (JD Souther), Rayna learns a little more about both her parents and the struggles that they kept from her. Meanwhile her sister makes a few discoveries of her own including finding out Teddy's (Eric Close) girlfriend (Kimberly Williams-Paisley) was responsible for leaking the story of Teddy and Rayna's divorce to the press.
Rather than cancel the show Juliette (Hayden Panettiere) decides to seize the opportunity to perform solo with several of her new songs leading to rising tensions with Deacon (Charles Esten) and her band. Feeling threatened by her sobriety coach (Jay Hernandez) shifting his focus more on Juliette's career than her sobriety, Jolene (Sylvia Jefferies) feels more and more on edge - especially after she learns the man looking after her best interests is sleeping with her daughter. Deacon's discovery of the situation only further complicates his relationship with Juliette, and he leaves the tour after the the New York show to visit Rayna in the hospital and spend some time at home with Stacey (Susan Misner).
And, in the episode's other ongoing storyline, Gunnar (Sam Palladio) and Scarlett (Clare Bowen) celebrate her record deal which culminates in Scarlett performing on-stage with Will (Chris Carmack) and Gunnar and Will tempting death which finally breaks Gunnar out of the funk he's been in since his brother's death and allows him to begin writing music again. Meanwhile Avery (Jonathan Jackson) finds new life as a roadie on Juliette's tour.
Even after missing a couple of episodes it doesn't seem like much has changed in the soapy world of Nashville. The show's strengths (a strong cast and good characters) continue to keep it afloat while Nashville attempts to hide its deficiencies (basic storytelling, slow-moving story arcs, and the lack of big time country music feel) behind a variety of soapy tales. There's not much of note music wise in "My Heart Would Know" as we hear only pieces of a couple of Juliette's songs during rehearsals and during the live performance. Gunnar's performance is really the only standout, which has more to do with the fact that he's writing music again than the song itself.
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