Hearing a rhythmic throbbing or whooshing sound in your ear is a common sensation. This internal sound, distinct from external noises, often prompts questions about its origin. Understanding this phenomenon involves exploring how our ears perceive internal sounds and the factors that make them noticeable.
What is Pulsatile Tinnitus?
Pulsatile tinnitus is an internal sound perception characterized by rhythmic noises synchronized with one’s heartbeat. It is commonly described as a whooshing, thumping, or throbbing sound heard in one or both ears. This differs from other forms of tinnitus, which typically involve ringing, buzzing, or hissing sounds not synchronized with the pulse. The sound is linked to blood flow or other mechanical processes near ear structures. Unlike other tinnitus types, pulsatile tinnitus often has an identifiable physical source.
Physiological Reasons for Hearing Your Pulse
Sometimes, hearing your pulse in your ear results from normal bodily functions. Intense physical activity, stress, anxiety, or fever can increase blood flow, making sounds of blood moving through vessels more audible. Temporary blood pressure changes also contribute. In quiet environments, the brain becomes more attuned to internal sounds, making normal blood flow noises more noticeable.
The anatomical proximity of major blood vessels to ear structures plays a role. Vessels in the neck, at the skull’s base, and within the ear are close to the auditory system. When blood flows quickly or with increased force, the sound transmits to the inner ear. This natural physiological response explains why many individuals occasionally perceive their pulse without a medical condition.
Medical Conditions Causing Pulsatile Tinnitus
Many medical conditions can cause pulsatile tinnitus, often involving changes in blood flow or structures near the ear. Vascular issues are common causes. Atherosclerosis, a hardening of the arteries due to plaque buildup, can create turbulent blood flow. High blood pressure can also increase blood flow audibility. Other conditions like venous hum (turbulent blood flow in the internal jugular vein) or arteriovenous malformations (abnormal connections between arteries and veins) can similarly lead to pulsatile tinnitus.
Ear-related conditions can also manifest as this symptom. These include otosclerosis, an abnormal bone growth in the middle ear, or glomus tumors, which are small, vascular growths often found in the middle ear. Fluid behind the eardrum or a perforated eardrum can alter sound perception, increasing awareness of internal body sounds. Systemic conditions also contribute; anemia (reduced red blood cells) can increase overall blood flow, while an overactive thyroid gland (hyperthyroidism) can speed up heart rate and blood circulation. Idiopathic intracranial hypertension, with increased fluid pressure around the brain, can also cause pulsatile tinnitus along with headaches and vision changes.
When to Consult a Healthcare Professional
Seek medical attention if you experience persistent or worsening pulsatile tinnitus. Certain signs indicate a need for professional evaluation. These include a sudden onset of the throbbing sound, if it affects only one ear, or if it is accompanied by other concerning symptoms.
Additional symptoms warranting consultation include dizziness, hearing loss, ear pain, or headaches. Vision changes, neurological symptoms like weakness or loss of sensation, or difficulty with balance also suggest prompt evaluation. A healthcare professional can assess these symptoms to determine if a serious underlying cause requires intervention.
Diagnostic Steps and Management Strategies
A medical evaluation for pulsatile tinnitus typically begins with a review of your medical history and a physical examination. The examination may include listening to the neck and head for bruits, sounds indicating turbulent blood flow. An audiological assessment helps evaluate your hearing.
Diagnostic tests identify the underlying cause. These can include imaging studies like MRI, MRA, CT scans, or angiography, which visualize blood vessels and brain structures. Blood tests may also check for systemic conditions like anemia or thyroid disorders. Management focuses on addressing the underlying cause. This may involve treating specific medical conditions, implementing lifestyle changes, or, if no treatable cause is found, managing the symptom through approaches like sound therapy.