Pulsatile tinnitus is the sensation of hearing one’s own heartbeat within the head. This rhythmic sound, often described as a whooshing or thumping, is a common and largely benign occurrence.
Understanding the Pulsating Sound
Pulsatile tinnitus distinguishes itself from other forms of tinnitus because the perceived sound directly corresponds to the individual’s heartbeat. It arises from the body’s vascular system, specifically blood vessels near the ear structures. The sound originates from turbulent blood flow as blood moves through arteries and veins.
Normally, blood flow sounds are imperceptible. However, increased blood flow intensity or enhanced ear sensitivity can make the rhythmic pulse audible. This sound is a real physiological event, amplified.
Everyday Reasons for the Sensation
Many common, non-threatening factors can lead to hearing one’s heartbeat within the head. Strenuous physical activity, like exercise, increases blood flow turbulence, making it audible. Stress or anxiety elevate heart rate and blood pressure, making blood flow sounds near the ears more pronounced. Caffeine can also temporarily increase cardiac output, contributing to this sensation.
Changes in the ear canal or middle ear can also make internal sounds more noticeable. An accumulation of earwax can block the ear canal, amplifying internal body noises, including the pulsing of blood. Dysfunction of the Eustachian tube can alter pressure within the ear, making it more sensitive to internal sounds. Certain medications, such as high doses of aspirin or some nonsteroidal anti-inflammatory drugs (NSAIDs), can temporarily induce this sensation. Lying down in a quiet room, especially on one’s side, can make normal blood flow audible by placing pressure on vessels or reducing external noise masking.
When It Might Be a Medical Concern
While often benign, pulsatile tinnitus can occasionally signal an underlying medical condition that warrants attention. Vascular issues are a frequent cause, such as carotid artery stenosis. This narrowing of the main artery in the neck can create turbulent blood flow that is heard as a whooshing sound. Intracranial hypertension, a condition involving elevated pressure within the skull, can also lead to pulsatile tinnitus by affecting blood flow dynamics in brain vessels. Dural arteriovenous fistulas, abnormal connections between arteries and veins in the brain’s covering, can produce a distinct pulsatile sound due to rapid, high-pressure blood flow.
Anemia, characterized by a low red blood cell count, can cause the heart to pump harder and faster to deliver oxygen, leading to increased and more turbulent blood flow that becomes audible. Thyroid disorders, particularly hyperthyroidism, accelerate the body’s metabolism and increase heart rate, which can result in more forceful blood circulation and noticeable pulsations. In rare instances, benign tumors located near the ear or along blood vessels can compress or interfere with normal blood flow, leading to pulsatile tinnitus. These conditions alter the flow, pressure, or volume of blood, making its movement audible.
Steps to Address the Sound
If the pulsating sound in your head persists, changes in character, or is accompanied by other symptoms like dizziness, vision changes, or sudden hearing loss, consulting a healthcare professional is advisable. A doctor will typically begin by taking a detailed medical history and conducting a physical examination, particularly focusing on the head, neck, and ears. This initial assessment helps to differentiate between common, temporary causes and potential underlying medical conditions.
Depending on the initial findings, further diagnostic tests such as blood work, to check for conditions like anemia or thyroid imbalance, or imaging studies like an MRI or CT scan of the head and neck, may be recommended to identify any underlying causes. Once a specific cause is identified, management strategies can be tailored. This may involve addressing the underlying medical condition directly, making lifestyle adjustments to manage factors like stress or caffeine intake, or utilizing sound therapy to help mask or habituate to the sound for comfort.