Pulsatile tinnitus is a rhythmic thumping, whooshing, or throbbing sound in your ear that often aligns with your pulse. Unlike other forms of tinnitus, its sound synchronizes with your heartbeat, making it identifiable by checking your pulse. While often harmless, it can occasionally signal an underlying medical condition and is more likely to have an identifiable source than other tinnitus types.
Understanding the Sensation
Hearing your heartbeat in your ear arises from the close proximity of major blood vessels to the ear’s delicate structures. Blood flowing through arteries and veins generates sound, and under certain conditions, these internal body sounds can become audible. The ear’s sensitive components, particularly within the inner ear, can pick up these sounds when blood flow changes or when the ear’s perception of sound is altered. This rhythmic noise typically beats at the same rate as the heart, often due to changes in blood flow near the ear or an increased awareness of it.
Common Explanations for the Sound
Many everyday situations can lead to temporarily hearing your heartbeat in your ear, often without serious implications. Sleeping in certain positions, such as with pressure on an ear or neck, can make the pulse sound more noticeable. Temporary congestion from colds, allergies, or sinus infections can muffle external sounds and amplify internal bodily noises. This can create a physical barrier that makes the sounds of blood flow more pronounced.
Stress or anxiety can elevate your heart rate and intensify blood flow, making the rhythmic sound more perceptible. Strenuous exercise also temporarily increases blood pressure and heart rate, leading to a more pronounced sound of blood circulation.
Earwax buildup or blockages can create a physical obstruction in the ear canal, which can amplify internal body sounds, including the heartbeat. Additionally, exposure to loud noise can temporarily alter ear sensitivity, making internal sounds more apparent. These common causes often lead to temporary pulsatile tinnitus that resolves on its own.
Underlying Health Considerations
While often benign, pulsatile tinnitus can sometimes signal more significant medical conditions. High blood pressure (hypertension) increases the force of blood flow through arteries, making the sound of blood moving through vessels near the ear more audible. The increased pressure on blood vessel walls can lead to turbulent blood flow and vibrations perceived as pulsatile tinnitus. Anemia, particularly iron deficiency anemia, can also be a factor because it increases blood flow and can make blood “thinner,” leading to more turbulent and noticeable flow. The heart may pump harder to deliver oxygen-rich blood, contributing to the audible sensation.
Thyroid conditions, specifically hyperthyroidism (an overactive thyroid), can increase the body’s metabolic rate and heart rate, resulting in increased blood flow that may cause pulsatile tinnitus. Atherosclerosis, the hardening and narrowing of arteries due to plaque buildup, can create uneven and turbulent blood flow, producing sounds heard as pulsatile tinnitus. This condition makes the insides of blood vessels lumpy, leading to noisier blood flow.
Vascular conditions, such as arteriovenous malformations (AVMs) or narrowed arteries and veins near the ear, can create abnormal blood flow patterns and sounds. Tumors in the head and neck, even benign ones, can also lead to abnormal blood vessels that result in pulsatile tinnitus. Certain medications, including some nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, and specific acne medications like tetracyclines, can affect blood pressure or ear function, potentially leading to pulsatile tinnitus. These drug-induced effects are often temporary and resolve once the medication is stopped or adjusted.
When to Seek Medical Advice and Next Steps
If you experience persistent pulsatile tinnitus, especially if it is new, concerning, or accompanied by other symptoms, consulting a healthcare provider is important. Seek medical advice if the sensation occurs in only one ear, or if it is accompanied by dizziness, hearing loss, or pain.
A doctor will typically begin with a thorough medical history and a physical examination of the head and neck. They may check your blood pressure, examine your ears, and listen for sounds in your neck or around your ear that synchronize with your pulse. Further diagnostic tests might include blood tests to check for conditions like anemia or thyroid problems. Imaging studies such as MRI, MRA (Magnetic Resonance Angiography), CT (Computed Tomography), or CTA (Computed Tomography Angiography) may also be recommended to evaluate the blood vessels and structures around the ear.
Once an underlying cause is identified, treatment can be targeted to address the specific condition. For benign cases, self-care tips can help manage the sensation. These include managing stress through relaxation techniques, adjusting sleeping posture to alleviate pressure on the ear, and maintaining proper hydration. While awaiting diagnosis, using sound therapy or white noise machines can offer temporary relief by providing a distraction from the internal sounds.