It sounds as if she is a heterozygous carrier of the
familialFamilial tremor hypercholesterolemia gene, which is very closely linked to premature coronary artery disease. The fact that she has a normal EKG only says that she has not had an event yet, but is at very high risk of doing so in the near future. Someone should spend some time to counsel her to take HMG Coa reductase inhibitors as these have conclusively been shown to improve cardiac outcomes in such patients.