What is angina pectoris primarily characterized by?

Angina pectoris is primarily characterized by pain or discomfort in the chest that occurs when the heart muscle doesn’t get enough oxygen-rich blood. This imbalance between the heart's demand for oxygen and the supply can happen during physical exertion, stress, or other factors that increase the heart's workload. The chest pain is a symptom indicating that the heart is not receiving adequate blood flow, often due to narrowed or obstructed coronary arteries.

The other options refer to different medical conditions or issues. While excessive fluid buildup in the lungs relates to heart failure, which can be a consequence of long-term angina or coronary artery disease, it does not describe the condition of angina itself. Inflammation of blood vessels, known as vasculitis, is a separate issue and not specific to angina pectoris. High cholesterol levels may contribute to the development of coronary artery disease that leads to angina, but they do not define the angina condition. Thus, focusing on the direct cause of angina pectoris highlights the critical relationship between blood supply and oxygen needs of the heart muscle.