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The indication of a potential pulmonary embolism is primarily associated with chest pain that exacerbates with breathing. This symptom reflects the irritation and inflammation of the pleura, which can occur due to a blockage in the pulmonary arteries by a blood clot. When a pulmonary embolism occurs, it can restrict blood flow to areas of the lung, leading to sharp chest pain—especially during deep breaths, coughing, or movement—as the body reacts to the reduced oxygen level and the resulting stress on the respiratory system.

The other symptoms, while they may indicate other health concerns, are not specific signs of pulmonary embolism. Severe back pain could relate to musculoskeletal issues or other conditions, long-lasting headaches might indicate various neurological problems, and general fatigue and weakness can result from a wide range of medical conditions. Hence, the specific symptom of chest pain that worsens with breathing is closely associated with the respiratory complications posed by a pulmonary embolism.