Panic attacks and heart disease

I read with interest this post from the Clinical Cases and Images blog which points to a paper in the Archives of General Psychiatry demonstrating a link between panic attacks and cardiovascular disease in postmenopausal women. But Dr. Wes in a blistering attack cites the study’s flaws and asks whether these women were in fact exhibiting heart disease symptoms misdiagnosed as panic attacks.

So what’s going on? From where I sit the study makes a contribution (albeit a weak one) to the growing body of evidence of a relation between panic disorder and heart disease. I previously posted evidence that myocardial perfusion abnormalities occur during panic attacks and cited an epidemiologic association.

A question remains. How many of the episodes of heart disease cited in the paper were actually examples of takotsubo cardiomyopathy, an under appreciated entity with a demonstrated preponderance in postmenopausal females strongly suspected to be a brain-heart disorder?
For a broader view of brain-heart disorders see my post here.