While often a harmless sensation, this rhythmic thumping or whooshing sound, known scientifically as pulsatile tinnitus, can occasionally signal an underlying medical condition. Understanding the nature of this sound and its potential origins helps to determine when medical attention might be beneficial.
Understanding the Pulsatile Sound
Pulsatile tinnitus presents as a rhythmic noise, such as a whooshing, thumping, or throbbing, that synchronizes with one’s heartbeat. Individuals can often confirm this by feeling their pulse while experiencing the sound. This differs from other forms of tinnitus, which typically involve constant sounds like ringing or buzzing without a discernible rhythm.
The sound arises from the ear’s perception of changes in blood flow within nearby blood vessels. These vessels include arteries and veins in the neck, at the skull’s base, and within the ear itself. When blood flows more turbulently or with increased force through these vessels, the sound can become audible. Factors like increased blood flow or a heightened sensitivity of the auditory pathways can contribute to this perception.
Potential Causes and Triggers
Many factors can lead to hearing one’s heartbeat in the ears, and identifying the cause is important for proper management. Benign causes often relate to temporary body changes or minor ear issues. Strenuous exercise, stress, and anxiety can increase blood flow and heart rate, making the sound more noticeable. Earwax buildup or temporary blockages in the ear canal can amplify internal body sounds, including blood flow. Certain medications, such as NSAIDs, may also induce pulsatile tinnitus. Pregnancy can also cause increased blood flow.
More concerning causes often involve conditions affecting the cardiovascular system or structures near the ear. High blood pressure can increase the force of blood flow through vessels, making pulsing sounds more audible. Anemia, particularly iron-deficiency anemia, can increase blood flow and the heart’s workload, leading to noticeable rhythmic sounds. Thyroid disorders, like an overactive thyroid, can also increase blood flow.
Conditions affecting blood vessels, such as atherosclerosis (hardening of the arteries), can create turbulent blood flow due to plaque buildup. Abnormalities in blood vessels, like arteriovenous malformations (AVMs) or narrowed arteries (stenosis), can also cause turbulent flow. Rare, highly vascular tumors near the ear, such as glomus tumors, can lead to pulsatile tinnitus. Idiopathic intracranial hypertension (increased fluid pressure around the brain) can also induce this symptom.
When Medical Consultation is Advised
While often harmless, certain signs warrant medical evaluation. Persistence of the sound, especially if it is continuous or significantly loud, should prompt a visit to a healthcare provider. If the pulsatile sound occurs in only one ear, it is often considered more indicative of an underlying issue.
Accompanying symptoms further suggest the need for professional assessment. These include dizziness, changes in vision, headaches, hearing loss, ear pain, or weakness. A healthcare provider can conduct an initial examination, which may involve listening to the neck and skull with a stethoscope to determine if the sound is objective (audible to the examiner) or subjective (only heard by the patient).
Diagnostic and Treatment Pathways
Once medical consultation is sought, healthcare providers employ various methods to diagnose the underlying cause of pulsatile tinnitus. A physical examination, including a thorough assessment of the head and neck, is typically the first step. Blood tests may be ordered to check for conditions like anemia or thyroid disorders.
Imaging studies are frequently used to visualize blood vessels and structures near the ear. These can include magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), computed tomography (CT) scans, or angiography. The choice of imaging depends on suspected causes and helps to identify vascular malformations, tumors, or other structural abnormalities.
Treatment for pulsatile tinnitus is entirely dependent on the identified cause. For example, if high blood pressure is the cause, medication and lifestyle changes may be recommended. Anemia might be treated with iron supplements. Earwax removal can resolve symptoms caused by blockages. In some cases, such as with certain vascular issues or tumors, surgical intervention may be necessary to correct the underlying problem. If no specific cause is found, sound therapy or masking devices, such as white noise machines, may help manage the perceived sound.