Jackhammer Esophagus Presenting as Chest Discomfort and Dyspnea in a Patient With Undifferentiated Inflammatory Arthritis and a Positive Scl-70 Antibody Test

Chest discomfort in patients with autoimmune connective tissue disease often prompts extensive cardiopulmonary evaluation, yet esophageal motility disorders remain an underrecognized etiology.In this report, we present a case of a 34-year-old woman with Raynaud's phenomenon, undifferentiated inflammatory arthritis (ANA-and Scl-70-positive), gastroesophageal reflux disease (GERD), and small intestinal bacterial overgrowth (SIBO) who developed progressive dyspnea and chest tightness following an influenza A infection.Despite an unremarkable broad initial workup that included computed tomography (CT) pulmonary angiography, echocardiography, and pulmonary function testing, high-resolution esophageal manometry with impedance, along with supplemental testing (endoluminal functional lumen imaging probe (EndoFLIP) and barium esophagram), ultimately supported a diagnosis of jackhammer esophagus (JE), a rare hypercontractile esophageal motility disorder.This case highlights JE as a rare and underrecognized cause of chest symptoms that should be considered when cardiopulmonary evaluation is unrevealing, particularly in patients with underlying autoimmune connective tissue disease, positive SSc serological markers, and a history of gastrointestinal disease.