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This is a reach, but the only condition I can conceive of that would produce vacuum at the exhaust, and still allow an engine to run would be for the exhaust valve (or valves) to be opening right after combustion, while the piston was going down on the fire stroke.
Did this condition happen all of a sudden, one day it was fine, the next day it was bad? Is it a problem that started slowly, and then got worse? Or was it after a re-assembly of some part of the valve train or ignition sequencing parts, like cam, distributor, cap, rotor, wires, timing belt, etc?
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