Illustration of a human ear with sound waves and a heartbeat symbol

Why Can I Hear My Heartbeat in My Ear? Understanding Pulsatile Tinnitus

  • May 28, 2024

Hearing your heartbeat in your ear – a condition scientifically termed ‘pulsatile tinnitus’ – can raise many questions and concerns, including “why can I hear my heartbeat in my ear?” Usually, this peculiar auditory experience stems from various blood flow changes in your body. By digging into the causal factors such as vascular irregularities or hypertension, our article provides crucial insights without overwhelming you with medical jargon. It’s the understanding you need in order to take the next steps towards addressing this often disconcerting experience.


Key Takeaways

  • Pulsatile tinnitus, affecting about 10% of tinnitus sufferers, is a rhythmic sound that syncs with the heartbeat, often caused by blood flow abnormalities or vascular diseases.
  • The causes of pulsatile tinnitus range from high blood pressure, vascular issues, and inner ear disturbances to potentially serious conditions like head and neck tumors, necessitating comprehensive medical evaluation and diagnosis.
  • Treatment for pulsatile tinnitus focuses on addressing the underlying cause, and may include medication, lifestyle changes, advanced procedures, and coping strategies, such as Tinnitus Retraining Therapy and Cognitive Behavioral Therapy.


Decoding the Rhythm: The Basics of Pulsatile Tinnitus

Illustration of a human ear with sound waves and a heartbeat symbol
Pulsatile tinnitus is a unique form of tinnitus, where individuals experience pulsatile tinnitus as a rhythmic concert within their ears. These sounds - often resembling whooshing, thumping, or throbbing - sync perfectly with each heartbeat, creating a peculiar rhythm. Picture a drummer, seated within your ear, beating rhythmically to the pulse of your heart. That, in essence, is the experience of subjective pulsatile tinnitus. Objective pulsatile tinnitus, though rare, can sometimes be heard by a healthcare professional during an examination.
Despite being a rare form of tinnitus, affecting only about 10% of tinnitus sufferers, it is a condition that commands attention. Unlike non-pulsatile tinnitus, which is typically noise-induced, pulsatile tinnitus often stems from blood flow abnormalities. Therefore, it’s pivotal to comprehend this condition as it will aid in its management and the potential health issues it may suggest.

Unraveling the Causes Behind Your Ear's Heartbeat

Pulsatile tinnitus is often a symphony conducted by underlying health conditions, primarily related to blood flow and vascular diseases. The causes range from high blood pressure to abnormalities in sinus walls and localized increases in blood flowing.


Delving into the specifics will illuminate how these conditions create the unique rhythmic thumping or whooshing sounds in your ear.


Vascular Issues and High Blood Pressure

Vascular irregularities play a significant role in causing pulsatile tinnitus. For instance, atherosclerosis of the carotid artery can lead to turbulent blood flow through narrowed vessel segments, creating a whooshing or thumping sound in the ear. Similarly, a high-riding jugular bulb can contribute to the condition and may even be visible as a blue mass behind the tympanic membrane during an otoscopy.


High blood pressure, or hypertension, is another key culprit. By increasing the turbulence of blood flow, it can amplify the sensation of a heartbeat in your ear. In fact, an ultrasound of the neck can help assess the impact of high blood pressure on blood vessels and noise perception in the ear.


Inner Ear Disturbances

In some cases, the culprit behind pulsatile tinnitus might reside closer to home - in your inner ear, to be precise. Abnormalities in the bones near the ear can cause individuals to hear internal sounds such as their heartbeat or blood flow. Imagine, for instance, an internal microphone picking up sounds that are usually inaudible, and broadcasting them to your conscious awareness.


One particularly interesting condition is the Superior semicircular canal dehiscence syndrome. This condition is characterized by a thinned or missing bone overlying the inner ear canal and can result in pulsatile tinnitus. Like any other condition, comprehending the cause is a significant step towards finding the right treatment.


Head and Neck Tumors

The cause of pulsatile tinnitus might sometimes be more serious and involve head and neck tumors. Glomus tumors, for instance, are vascular neuroendocrine tumors that can cause pulsatile tinnitus by pressing on blood vessels and changing blood flow. These tumors usually arise from glomus cells located in the jugular vein beneath the middle ear.


One particular type, the glomus tympanicum, can be visually identified as reddish pulsatile masses behind the tympanic membrane, leading to the symptom of pulsatile tinnitus. Therefore, a comprehensive medical evaluation is of utmost importance when dealing with pulsatile tinnitus.


Understanding the Role of Hydrogen Peroxide in Ear Care

Did you know hydrogen peroxide is a potent weapon against earwax? It’s a cerumenolytic solution, meaning it can soften and dissolve earwax, making it easier to remove. Over-the-counter (OTC) otc ear drops often contain a hydrogen peroxide solution, typically in a concentration of around 3%.


When the Beat Does Not Go On: Symptoms of Pulsatile Tinnitus

While the primary symptom of pulsatile tinnitus is the rhythmic thumping or whooshing sound, the condition often doesn’t stop there. Imagine trying to concentrate on a task or drift off to sleep while a constant, rhythmic sound plays in your ear. This condition can significantly interrupt concentration and sleep, disrupting daily activities and making it difficult to focus on work or personal tasks.


The intensity and presence of pulsatile tinnitus sounds can vary, sometimes becoming loud enough to interfere with daily life, and may come and go, being particularly noticeable after exercise. Moreover, mental health can greatly influence the condition’s severity, with symptoms likely to intensify during stressful periods, indicating a possible need for simultaneous mental health treatment.


Seeking Clarity: Diagnosis of Pulsatile Tinnitus

Diagnosing pulsatile tinnitus is a multi-step process that begins with a comprehensive hearing test to assess the function of the auditory system. Imaging tests such as:


  • Doppler ultrasound
  • CT scans
  • MRI scans
  • CT angiography


A detailed look at the structures within one or both ears can help identify any vascular causes of pulsatile tinnitus.


A thorough medical evaluation, including a head and neck exam, is also an essential part of the diagnostic process. In some cases, pulsatile tinnitus can indicate a more serious underlying condition such as brain aneurysms, which requires careful monitoring and treatment. Thus, if you experience symptoms of pulsatile tinnitus, it’s imperative to seek a medical evaluation promptly.


Harmonizing Health: Treatment Options for Pulsatile Tinnitus

Illustration of medication and lifestyle adjustments
After being diagnosed, the primary focus of treating pulsatile tinnitus is to address the underlying cause. This helps to effectively manage the condition and its symptoms. Treatments for pulsatile tinnitus include:
  • Medication
  • Lifestyle changes
  • Advanced procedures
  • Coping mechanisms and support


We will now examine these treatment options in detail.


Medication and Lifestyle Adjustments

High blood pressure is often a contributing factor to pulsatile tinnitus. Therefore, managing it through medication, a nutritious diet low in sodium, and regular exercise can alleviate symptoms of both high blood pressure and pulsatile tinnitus. In some cases, weight loss may be recommended, especially for patients with idiopathic intracranial hypertension, as it can help manage this condition.


Treating underlying conditions, such as hyperthyroidism or anemia, can also alleviate the symptoms of pulsatile tinnitus related to these disorders. Therefore, a comprehensive treatment approach that includes both medication and lifestyle changes is frequently the most effective method.


Advanced Treatments and Procedures

In some cases, more advanced pulsatile tinnitus treatment options may be necessary. For instance, otological or neurological surgery may be recommended when pulsatile tinnitus results from blood vessel disorders, malformations, tumors, or ear abnormalities. Minimally invasive image-guided catheter-based procedures, as well as stenting, are advanced treatments that can successfully address certain causes of pulsatile tinnitus, such as dural arteriovenous fistula and aneurysms.


For conditions like dural arteriovenous fistulas, which may lead to pulsatile tinnitus and pose a risk of rupture and cerebral hemorrhage, targeted image-guided catheter-based interventions are available. Similarly, carotid stenosis, another condition associated with pulsatile tinnitus, can be treated through a range of procedures including medication, image-guided interventions, or surgical options.


Coping Mechanisms and Support

Although medical treatments and procedures are vital in managing pulsatile tinnitus, coping strategies and support play an equally significant role. Some effective strategies include:


  • Sound therapy, which can help suppress the thumping or whooshing sound of pulsatile tinnitus
  • Cognitive behavioral therapy, which can help patients develop healthier thought patterns and coping mechanisms
  • Meditation and relaxation techniques, which can reduce stress and improve overall well-being


These strategies can help patients mitigate distress and improve their ability to cope with pulsatile tinnitus.


These therapies help individuals better understand and manage their condition, allowing them to regain control over their symptoms and maintain a high quality of life. Hence, these coping strategies should be regarded as a fundamental component in the treatment journey for those living with pulsatile tinnitus.


Navigating Day-to-Day Life with Pulsatile Tinnitus

Living with pulsatile tinnitus requires patience, understanding, and the right tools. Different types of sound therapies, such as Tinnitus Retraining Therapy (TRT), can help manage daily symptoms. Cognitive Behavioral Therapy (CBT) can also be a valuable tool for those living with pulsatile tinnitus, helping to cope with the condition’s impact on mental well-being.


Engaging in relaxation exercises and mindfulness techniques can also be beneficial for managing pulsatile tinnitus symptoms. Remember, you’re not alone in this journey. Counseling services can provide support and strategies, helping to navigate daily challenges. Maintaining good mental health is vital for controlling the condition, as stress can trigger the flare-ups of pulsatile tinnitus.



In conclusion, pulsatile tinnitus is a complex condition with multiple potential causes, from blood vessel abnormalities to head and neck tumors. Its rhythmic thumping or whooshing sounds can disrupt daily life, but with the right diagnosis, treatment, and coping strategies, it’s possible to tame the rhythm and regain control. Remember, every heartbeat is a rhythm of life; understanding it is the first step towards harmonizing health. Any other questions please contact a healthcare professional


Frequently Asked Questions


What is pulsatile tinnitus?

Pulsatile tinnitus is a form of tinnitus characterized by a rhythmic thumping or whooshing sound in the ear that synchronizes with the heartbeat.


What causes pulsatile tinnitus?

Pulsatile tinnitus can be caused by conditions related to blood flow and vascular diseases, abnormalities in the bones near the ear, or head and neck tumors. It's essential to seek medical evaluation for proper diagnosis and treatment.


How is pulsatile tinnitus diagnosed?

Pulsatile tinnitus is diagnosed through a comprehensive audiologic evaluation, Doppler ultrasound, CT scans, MRI scans, and a thorough medical examination. Imaging tests and a thorough evaluation are essential for accurate diagnosis.


What are the treatment options for pulsatile tinnitus?

The treatment options for pulsatile tinnitus may involve addressing the underlying cause, medication, lifestyle adjustments, advanced treatments such as surgery or image-guided procedures, and coping mechanisms like sound therapy and cognitive behavioral therapy. Surgery and image-guided procedures are considered advanced treatment options for addressing pulsatile tinnitus.


How can I cope with pulsatile tinnitus in daily life?

You can cope with pulsatile tinnitus in daily life by using sound therapies, cognitive behavioral therapy, meditation, relaxation exercises, and counseling services. These methods can help manage the symptoms and improve your quality of life.