Pulsatile tinnitus is a rhythmic sound in the ear that follows your heartbeat, often described as hearing a pulse in one ear. In this article, we explore its causes, common symptoms, and the most effective treatments available.
Pulsatile tinnitus is a form of tinnitus where the individual perceives a rhythmic sound that is often synchronised with their heartbeat. Unlike the more common form of tinnitus, which typically involves constant ringing or buzzing, pulsatile tinnitus is described as a "whooshing" or "thumping" noise. Many people refer to it as the sensation of hearing their heartbeat in ear.
This type of tinnitus is generally caused by blood flow changes or abnormalities near the ear, and it may occur in one or both ears. While sometimes benign, pulsatile tinnitus can also signal an underlying vascular or neurological condition that requires medical attention.
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Pulsatile tinnitus can be unilateral (affecting one ear) or bilateral (affecting both ears).
Unilateral pulsatile tinnitus may be more concerning, as it could indicate a localised issue such as a vascular abnormality or a growth near the ear. It should be evaluated by a medical professional without delay. Bilateral pulsatile tinnitus, while still needing medical evaluation, is more likely to be associated with systemic factors such as high blood pressure or increased intracranial pressure.
Whether it’s in one ear or both, pulsatile tinnitus should never be ignored, especially if it becomes persistent or interferes with daily life.
A cold or upper respiratory infection can lead to temporary pulsatile tinnitus. Nasal congestion and inflammation can affect the Eustachian tube, which in turn alters pressure in the middle ear. This pressure imbalance may cause sensations such as hearing a heartbeat in the ear.
Symptoms usually resolve as the cold clears, but if the pulsating sound persists, it's advisable to seek medical attention.
Anxiety can significantly impact how you perceive sounds, including internal bodily noises. During heightened states of stress or panic, increased heart rate and blood pressure can make the hearing of one's heartbeat in the ear more noticeable.
While anxiety may not be the root cause, it can amplify the awareness of pulsatile tinnitus. Addressing the underlying anxiety through therapy, lifestyle changes, or stress management may reduce the perception of symptoms.
Emerging studies and patient reports have linked COVID-19 with various auditory symptoms, including pulsatile tinnitus. The virus may affect the inner ear or cause inflammation in blood vessels near the auditory system, leading to new-onset or worsening tinnitus.
If you’ve recently had COVID-19 and are experiencing hearing a heartbeat in your ear, it’s important to consult a healthcare provider for a thorough evaluation.
An ear infection, particularly affecting the middle ear, can lead to fluid accumulation, inflammation, and pressure changes that alter sound perception. These changes may occasionally result in pulsatile tinnitus, especially when nearby blood vessels are affected or pressure interferes with normal auditory function.
Conditions such as acute otitis media, chronic otitis media with effusion, and mastoiditis have been associated with pulsatile tinnitus in some patients. These infections can create a conductive hearing issue or disturb blood flow in the adjacent vascular structures of the ear.
Excessive earwax (cerumen) can block the ear canal and alter how sound travels, sometimes amplifying internal sounds like the pulse. This can result in a form of pulsatile tinnitus that often resolves once the blockage is removed.
Avoid using cotton buds to remove earwax, as this can worsen the blockage or cause injury. Instead, seek professional cleaning if needed.
Exposure to loud noises, whether sudden (e.g., explosions) or prolonged (e.g., concerts, industrial settings), can damage the delicate structures of the inner ear, leading to noise-induced hearing loss. While this typically results in non-pulsatile tinnitus, in some cases, it may also trigger pulsatile tinnitus, especially if vascular damage or increased sensitivity follows the exposure.
Wearing hearing protection and limiting exposure to high-volume environments is crucial for preventing all forms of tinnitus, including both non-pulsatile and pulsatile types.
Being proactive about your well-being is crucial. Don’t wait—book a free consultation today to protect your hearing, especially if you’re experiencing pulsatile tinnitus. Take control and get expert advice tailored to your needs.
Treatment for pulsatile tinnitus largely depends on identifying and addressing its underlying cause. Often linked to vascular problems, ear infections, high blood pressure, or structural abnormalities near the auditory system, management strategies vary accordingly.
Common approaches include:
In some cases, medications like aspirin may be reconsidered, as while it has cardiovascular benefits, it can sometimes worsen tinnitus symptoms. If aspirin use aligns with the onset or aggravation of pulsatile tinnitus, your healthcare provider may adjust your dosage or suggest alternatives.
Additional treatment options include:
Consultation with an audiologist or an ENT specialist is crucial to tailor the most effective management plan for your situation.
Keep yourself updated on tinnitus and related hearing issues by exploring our informative blog posts.
In some cases, pulsatile tinnitus becomes more noticeable or changes in intensity with specific head positions or body posture. This may be due to altered blood flow, neck muscle tension, or venous drainage changes that affect circulation near the auditory system. Lying down, tilting the head, or turning to one side may either amplify or reduce the pulsing sensation in the ear.
This positional sensitivity may indicate a vascular origin, such as venous sinus stenosis or a carotid artery issue. Noting when the sound changes—particularly in relation to posture—can help healthcare providers in identifying the underlying cause. A thorough clinical assessment, often including imaging, is recommended when positional tinnitus is present.
While pulsatile tinnitus is not always dangerous, it should never be ignored. In many cases, it may result from benign conditions such as middle ear infections, earwax build-up, or temporary blood pressure changes. However, it can also signal serious underlying health issues, such as:
If pulsatile tinnitus is unilateral, persistent, or accompanied by other symptoms like headaches, hearing loss, or visual changes, it is important to undergo a comprehensive ENT or neurological evaluation to rule out more serious conditions.
Tinnitus generally falls into two main categories: pulsatile and non-pulsatile.
Distinguishing between the two types is crucial, as pulsatile tinnitus often requires medical imaging and a different diagnostic approach to rule out vascular or neurological causes.
Pulsatile tinnitus can be classified as acute or chronic, depending on its duration and underlying cause.
Understanding whether the tinnitus is acute or chronic is key to determining the appropriate management plan.
Pregnancy can lead to the development or worsening of pulsatile tinnitus due to significant physiological and hormonal changes. During pregnancy, blood volume and cardiac output increase, which can heighten awareness of vascular sounds, particularly in sensitive individuals.
In most cases, the condition is temporary and resolves after childbirth. However, pulsatile tinnitus during pregnancy may also be linked to more serious concerns such as pre-eclampsia, which involves high blood pressure and should be addressed immediately.
Pregnant individuals experiencing pulsatile tinnitus—especially if accompanied by headaches, visual disturbances, or dizziness—should seek medical evaluation to ensure both maternal and foetal wellbeing.
In some cases, intense physical activity or strenuous exercise may temporarily lead to or worsen pulsatile tinnitus. During exercise, heart rate and blood pressure naturally increase, which can result in heightened awareness of vascular sounds, particularly in individuals with existing sensitivity or underlying vascular conditions.
Weightlifting, high-intensity cardio, or activities involving straining or Valsalva manoeuvres (e.g. holding the breath during exertion) can alter intracranial pressure or venous return, sometimes triggering a rhythmic, pulse-synchronised sound in the ears.
While headphones are more commonly associated with non-pulsatile tinnitus due to prolonged exposure to loud volumes, they are less likely to directly cause pulsatile tinnitus. However, using headphones at excessive volume can lead to noise-induced hearing damage, which may make any underlying vascular sounds more noticeable.
In rare cases, headphone use may indirectly contribute to pulsatile tinnitus if it leads to temporary hearing threshold shifts, earwax impaction, or inner ear strain. Over-ear and in-ear headphones that are worn for extended periods without breaks may also cause ear canal irritation or blockage, altering how sound is perceived.
To reduce risk, it is recommended to follow the 60/60 rule: listen at no more than 60% volume for no more than 60 minutes at a time, and take regular breaks.
Yes, most individuals with pulsatile tinnitus can safely fly, though some may experience temporary worsening of symptoms during ascent or descent due to changes in air pressure. This can affect middle ear function and Eustachian tube performance, especially if the tinnitus is linked to ear infections, sinus issues, or pressure imbalances.
To ease discomfort, consider:
If pulsatile tinnitus is accompanied by ear pain, infection, or other complications, it’s advisable to seek medical advice before flying. In rare cases involving significant vascular abnormalities, your doctor may recommend further evaluation before air travel.
You may hear your heartbeat in your ear due to a condition called pulsatile tinnitus. This occurs when you hear a rhythmic sound that usually matches your heartbeat. Common causes include:
If this sensation is frequent or persistent, it's best to consult a doctor or audiologist for a thorough evaluation.
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