Pulsatile tinnitus is a type of tinnitus where you hear a rhythmic sound that seems to beat in time with your heartbeat. Unlike typical tinnitus, which might cause constant ringing or buzzing, this form produces a whooshing, thumping, or pulsing noise that matches your pulse. It’s a real sensation that can occur in one or both ears, and only the person experiencing it hears the sound.
While many people notice occasional internal sounds (especially in very quiet environments), pulsatile tinnitus that persists or feels pronounced should be taken seriously and medically evaluated.
Why Does It Happen? The Role of Blood Flow
In most cases, what you’re actually hearing is your own blood flow in vessels near the ear. There are a few common reasons this becomes noticeable:
- Circulation changes or turbulence: When blood flows forcefully or irregularly through arteries and veins near the ear, the sound can carry into the inner ear. Conditions such as high blood pressure or atherosclerosis (hardening or narrowing of vessels) are frequent contributors.
- Vascular abnormalities: Structural issues like arteriovenous malformations (small tangled blood vessels) or vein irregularities can amplify blood flow sounds.
- Neck or skull vessel issues: Narrowed carotid or jugular vessels, or sinus wall irregularities near the ear, can create the characteristic pulsing noise.
- Other influences: Conditions like anemia, thyroid imbalance, and increased intracranial pressure (fluid around the brain) can also change blood flow dynamics, making the pulse sound more audible.
For some people, even strenuous exercise or elevated heart rate can make the pulse in the ears momentarily louder or more noticeable.
How It Feels
People with pulsatile tinnitus often describe the sound as:
- A steady or throbbing beat
- A whooshing or swishing noise
- A rhythmic pulse that speeds up with heart rate and slows down when resting
- Unlike a simple internal “pressure” sensation, this sound clearly matches each heartbeat and can be persistent — especially in quiet environments or at night.
How It’s Diagnosed
Because pulsatile tinnitus often points to an underlying vascular or circulatory cause, doctors typically take it seriously. Diagnosis may involve:
- Medical history and physical exam
- Listening with a stethoscope to see if a clinician can detect the sound too
- Hearing tests to check for associated hearing loss
- Imaging (like MRI or ultrasound) to look at vessels around the neck and ear
- In some cases, a cardiologist or neurologist may be involved to assess blood flow and rule out serious issues.
Treatment and What to Do
Treatment depends on what’s causing the symptom. Often, addressing the underlying vascular condition — such as controlling high blood pressure or correcting vessel abnormalities — can reduce or eliminate the sound. In situations where no specific cause is found but the noise is bothersome, doctors may suggest sound therapy or coping strategies to help manage the perception of the pulse.
When to Seek Medical Advice
You should consider seeing a healthcare provider if you notice:
- A persistent heartbeat-like sound in your ear
- The sound appears suddenly or is only in one ear
- It’s accompanied by dizziness, vision problems, headache, or changes in hearing
- This sound can sometimes be one of the first signs of a treatable health condition, so professional evaluation is important, especially if it doesn’t go away on its own.
