Tinnitus is the medical term for perceiving a sound in the ears or head when no external noise source is present. This auditory sensation is a symptom, not a disease, affecting millions globally. While most individuals experience a persistent, steady noise, a less common form is pulsatile tinnitus. This variant is distinct because the sound is a rhythmic noise that often corresponds precisely to the listener’s own heartbeat.
The Distinct Sounds of Pulsatile Tinnitus
The most frequently described sounds are rhythmic and deeply resonant, aligning with the pace of the heart. People often report hearing a distinct “whooshing” or “swooshing” sound, similar to blood rushing through a vessel. The auditory experience can be compared to a fetal heartbeat heard through an ultrasound or water surging through a narrow pipe.
Other common descriptions include a noticeable “thumping” or “throbbing” sensation inside the ear canal or head. In some cases, the sound may be a sharper “clicking” or “hissing,” but the defining characteristic remains synchronization with the circulatory system. A simple way to confirm the sound is by checking one’s pulse; the internal noise will beat at the exact same rate. This rhythmic sound is often more noticeable when the environment is quiet, such as when lying down.
The Physiological Link to Heartbeat and Blood Flow
The rhythmic sound often originates from a physical sound generated within the body. This means the sound is frequently “objective,” suggesting a doctor can sometimes detect it by listening with a stethoscope near the ear or neck. The sound waves are created by changes in blood flow dynamics within the large arteries and veins located near the middle and inner ear structures.
Blood normally flows smoothly through vessels, but turbulent flow creates noise. This turbulence can occur due to a narrowing of a blood vessel (stenosis) or a sudden increase in the volume or velocity of blood flow. For example, a partial blockage in the carotid artery or an irregularity in the jugular vein can cause the blood to swirl and vibrate, generating an audible sound. The proximity of these major vessels to the ear allows the internal vibrations to be transmitted and perceived as a rhythmic noise.
How Pulsatile Tinnitus Differs from Standard Tinnitus
Pulsatile tinnitus is set apart from the more common non-pulsatile tinnitus by its rhythmic, pulse-synchronous nature. Standard tinnitus is typically described as a static, continuous sound, such as a high-pitched ring, a steady hiss, or a constant buzz. Crucially, the noise in standard tinnitus does not have a discernible beat and is not synchronized with the patient’s heart rate.
The underlying origin of the two conditions also differs. Non-pulsatile tinnitus is usually subjective, meaning only the patient can hear it, and is most frequently associated with damage to the auditory system, such as hearing loss. In contrast, the rhythmic nature of pulsatile tinnitus suggests a vascular or structural anomaly is often the source. This distinction means pulsatile tinnitus is more likely to have an identifiable physical cause diagnosed through medical imaging or other physical examination techniques.