Hearing one’s own heartbeat in the ear, a whooshing or thumping sound, is known as pulsatile tinnitus. This rhythmic noise typically aligns with the individual’s pulse. While unsettling, it doesn’t always indicate a serious health condition. Understanding its origins helps individuals determine when to seek professional guidance.
Understanding Pulsatile Tinnitus
Pulsatile tinnitus is a rhythmic sound, like a whooshing or thumping, that synchronizes with one’s heartbeat. This differs from other tinnitus forms, which involve continuous ringing, buzzing, or hissing noises. The sound often results from altered blood flow or increased blood turbulence in vessels near the ear, or from an increased awareness of normal blood flow.
Various factors contribute to pulsatile tinnitus. Vascular issues are a common cause, often creating turbulent blood flow. Atherosclerosis, involving plaque buildup and artery narrowing, can lead to noisy blood flow in vessels near the head and neck.
Abnormalities like arteriovenous malformations (AVMs) or aneurysms can also cause turbulent flow. High blood pressure increases blood flow force, making it more noticeable. Venous issues, such as narrowing of large brain veins (venous sinus stenosis) or sinus wall abnormalities, can also alter blood flow and create the characteristic sound.
Musculoskeletal factors can also play a role. Muscle spasms in the middle ear or neck muscles can produce rhythmic sounds, sometimes described as clicking or crackling. These sounds differ from blood flow noises and are often triggered by movement or external stimuli. Ear-related conditions may also contribute by increasing awareness of internal body sounds. Conductive hearing loss, caused by issues like a perforated eardrum or fluid in the middle ear (glue ear), can make a person more sensitive to normal blood flow noises.
Systemic conditions affecting the entire body can also manifest as pulsatile tinnitus. Anemia, particularly iron-deficiency anemia, can increase blood flow velocity as the heart works harder to deliver oxygen, making blood flow audible. An overactive thyroid gland (hyperthyroidism) can also lead to increased heart rate and blood flow.
Idiopathic intracranial hypertension (IIH), involving elevated cerebrospinal fluid pressure around the brain, can affect blood vessels and cause pulsatile tinnitus, often with headaches and vision changes. Tumors in the head or neck, especially vascular ones like glomus tumors, can press on nearby blood vessels or create abnormal blood flow patterns. Head trauma and Paget’s disease are other less common systemic causes.
When to Seek Professional Medical Advice
While pulsatile tinnitus can be benign or temporary, certain indicators warrant prompt medical evaluation. A new onset of this symptom, or if it persists for several days or weeks, suggests the need for professional assessment. A doctor can help determine if the sound is a symptom of a treatable or serious underlying condition.
Specific “red flag” symptoms accompanying pulsatile tinnitus necessitate immediate medical attention. These include sudden onset, especially if in only one ear. Accompanying symptoms such as dizziness, severe headache, vision changes, or any neurological symptoms like new weakness or loss of sensation are particularly concerning. A history of cardiovascular issues or vascular disease also makes medical consultation more urgent.
Strategies for Home Management
When a serious underlying cause for pulsatile tinnitus has been ruled out or while awaiting medical evaluation, several home management strategies can help alleviate or cope with the symptom. Sound masking techniques involve introducing external sounds to make the internal heartbeat noise less noticeable. Using white noise machines, fans, or soft music, particularly at bedtime, can help mask the rhythmic sound and improve sleep quality.
Stress reduction techniques can also be beneficial, as stress and anxiety can worsen tinnitus perception. Practices such as meditation, deep breathing exercises, and yoga may help calm the nervous system and reduce the intensity of the perceived sound. Engaging in regular physical activity can also help reduce stress and improve overall well-being, potentially lessening tinnitus impact.
Lifestyle adjustments can support symptom management. Avoiding stimulants like excessive caffeine and nicotine, which increase heart rate and blood flow, may reduce pulsatile tinnitus prominence. Reducing salt intake can also be helpful, particularly if linked to blood pressure fluctuations. Ensuring adequate rest and a healthy sleep schedule can prevent the symptom from feeling more pronounced due to fatigue. These home-based approaches primarily offer coping mechanisms and symptom reduction, and are best implemented after medical evaluation.
Professional Diagnostic Approaches and Treatments
Diagnosing pulsatile tinnitus typically begins with a thorough medical history and physical examination. The doctor will inquire about the sound’s characteristics, including its duration, frequency, and any associated symptoms. A physical examination often includes checks of the ear, neck, and head to identify abnormalities or listen for objective sounds (bruits).
Imaging tests are frequently used to investigate the underlying cause. These may include Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) to visualize blood vessels and soft tissues, or Computed Tomography (CT) and CT Angiography (CTA) for detailed bone and vessel assessment. These scans help identify vascular malformations, narrowed arteries or veins, or tumors near the ear and head. Audiology tests might also be performed to assess hearing and rule out conductive hearing loss or other ear-related issues.
Treatment for pulsatile tinnitus depends on the identified underlying cause. If high blood pressure is a factor, medication combined with lifestyle changes like diet and exercise can help reduce the sound. For conditions like anemia or hyperthyroidism, treating the systemic disorder with appropriate medications or supplements can resolve the pulsatile tinnitus.
In cases of structural abnormalities, medical interventions may be necessary. Surgical procedures can address vascular malformations, such as arteriovenous malformations or aneurysms, by correcting abnormal blood flow. Stenting might be used to widen narrowed veins or arteries, improving blood flow and alleviating the sound. Tumors, if identified as the cause, may require surgical removal or other treatments like radiation therapy. When a specific cause is treated, pulsatile tinnitus often resolves or significantly improves, underscoring the importance of accurate diagnosis.