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The key sign of an abdominal aortic aneurysm (AAA) is the sudden onset of severe abdominal or back pain. This pain typically occurs as the aneurysm expands or ruptures, leading to irritation of surrounding structures and significant internal bleeding. The severity and acute nature of the pain are critical indicators, as they can help differentiate an AAA from other abdominal or back conditions.

In cases of AAA, patients may describe the pain as tearing or ripping, and it often radiates to the back or flanks due to the anatomical position of the aorta. Recognizing this symptom is crucial for emergency intervention, as timely management can be life-saving.

While gradual chest pain can be associated with other cardiac conditions, persistent nausea and vomiting may suggest gastrointestinal issues or other non-specific causes. Increased heart rate can occur in various types of shock or pain but is not specific to AAA. The primary distinguishing feature of AAA is indeed the sudden, severe discomfort in the abdominal or back region.