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Chest pain is a common symptom associated with pulmonary embolism due to the obstruction of blood flow in the pulmonary arteries. When a clot lodges in these arteries, it causes ischemia to the lung tissue, resulting in sharp or pleuritic chest pain that may worsen with deep breathing or coughing. The pain is often described as sudden in onset and can be accompanied by other symptoms such as shortness of breath, anxiety, or tachycardia.

Understanding the context of the other symptoms helps clarify why chest pain is particularly significant in this scenario. Unilateral leg swelling is often indicative of deep vein thrombosis (DVT), which may precede a pulmonary embolism, but it is not a direct symptom of the embolism itself. A persistent cough can occur in various respiratory conditions, not exclusively pulmonary embolism. Hyperventilation might be observed as a response to anxiety or hypoxia that can result from an embolism, but it is not a hallmark symptom and can arise from other conditions as well. Overall, chest pain stands out as a key and defining symptom in the diagnosis of pulmonary embolism.