While our bodies produce many internal sounds, individuals sometimes become aware of a distinct noise within their ears, often described as hearing their own blood flow. This sensation can be unsettling, prompting concerns about its origin and implications. Understanding this phenomenon can help alleviate anxiety and guide individuals toward appropriate steps.
The Nature of the Sound
Hearing blood flow in the ears typically refers to pulsatile tinnitus. Unlike common tinnitus, which is a constant ringing or buzzing, pulsatile tinnitus is a rhythmic noise. It often synchronizes with one’s heartbeat, sounding like a whooshing, throbbing, or humming.
This distinctive sound can be verified by checking one’s pulse while listening to the noise; if they match, it indicates pulsatile tinnitus. While a heartbeat can be heard during strenuous exercise, individuals with pulsatile tinnitus perceive this sound even at rest. The sound can be intermittent or constant, varying in intensity and sometimes interfering with daily activities or sleep.
What Causes This Sensation?
Pulsatile tinnitus typically arises from changes in blood flow within vessels near the ear or an increased awareness of that flow. These vessels include arteries and veins in the neck, skull base, and within the ear.
Vascular issues are a common cause, where abnormalities in blood vessels near the ear create turbulent blood flow. Conditions like atherosclerosis (hardening and narrowing of arteries) can make blood flow more forceful. Narrowing of neck arteries or brain veins can disrupt smooth flow, leading to whooshing sounds. Abnormal connections between arteries and veins (AVMs or fistulas) or bulges in vessel walls (aneurysms) can also cause turbulent flow.
Increased blood flow states can also lead to pulsatile tinnitus. Conditions such as anemia or hyperthyroidism can increase overall blood flow and cardiac output, making the sound more pronounced. High blood pressure can cause blood to flow more forcefully, generating audible noise. Pregnancy and strenuous exercise can also temporarily increase blood flow.
Problems within the ear structure, known as conductive hearing issues, can amplify internal body sounds. Conditions like fluid in the middle ear or significant earwax can block external sounds, making internal sounds more noticeable. A persistent stapedial artery, which remains open in some individuals, can also generate pulsatile tinnitus due to its proximity to middle ear structures.
Other factors can also contribute to this sensation. Idiopathic intracranial hypertension (IIH), a condition characterized by increased pressure of the fluid surrounding the brain, can compress blood vessels and cause turbulent flow. Certain types of tumors near the ear can create abnormal blood vessels or press on existing ones, leading to audible blood flow. Head trauma has also been associated with pulsatile tinnitus in some cases.
When to Be Concerned
While pulsatile tinnitus can sometimes be benign, it is important to seek medical advice because it can be a symptom of an underlying condition that requires attention. You should contact a healthcare provider if the sound is persistent, unilateral (heard in only one ear), or if it is a new and unexplained sensation. These characteristics can be red flags that indicate a more specific issue.
Additional symptoms accompanying pulsatile tinnitus also warrant immediate medical evaluation. These include dizziness, changes in hearing, severe headaches, or vision problems. Difficulty walking, balance issues, or sudden chest pain with other cardiac symptoms should prompt urgent medical attention. Recognizing these associated symptoms can help in timely diagnosis and management of any potential health concerns.
Medical Evaluation and Approaches
A medical evaluation for pulsatile tinnitus typically begins with a detailed medical history and a thorough physical examination. During the examination, a healthcare provider may use a stethoscope to listen to the neck and skull, attempting to hear the pulsatile noise. If the sound is audible to the examiner, it is referred to as objective pulsatile tinnitus; otherwise, it is subjective.
Further investigations often include hearing tests to assess auditory function. Imaging studies are frequently used to visualize the blood vessels and structures in the head and neck, helping to identify the underlying cause. These may include Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scans, Magnetic Resonance Angiography (MRA), or CT Angiography (CTA), which provide detailed images of blood vessels and surrounding tissues. In some cases, blood tests may be performed to check for systemic conditions such as anemia or thyroid disorders.
The management of pulsatile tinnitus involves treating the underlying cause. If high blood pressure is identified, medication and lifestyle changes such as diet and exercise may be recommended. Anemia can be addressed with medication or blood transfusions, while an overactive thyroid can be managed with medication. In cases involving specific blood vessel abnormalities or tumors, surgical intervention or other procedures like stenting may be necessary to correct the issue. When a specific medical cause cannot be treated, sound therapy using white noise or masking devices can help make the pulsatile sounds less noticeable.