Paroxysmal thoracic pain, often radiating to the arms, particularly the left, sometimes accompanied by a feeling of suffocation and impending death, most often due to ischemia of the myocardium and precipitated by effort or excitement, occurring in attacks of predictable frequency and duration after provocation by circumstances that increase myocardial oxygen demands, such as exercise, emotional stress, or excitement, the precipitating circumstances tending to remain constant across episodes.