Hearing your heartbeat in your ear (pulsatile tinnitus) can be caused by high blood pressure, earwax, or a blood flow problem. See a doctor if it persists.
What it is
Pulsatile tinnitus is hearing your pulse in the ear.
Common causes
- High blood pressure.
- Earwax or ear infection.
- Anemia.
- Thyroid problems.
- Blood vessel abnormalities.
- Idiopathic intracranial hypertension.
Is it serious
Often not, but check it out.
See a doctor
Soon, especially if one sided.
Emergency
Sudden hearing loss or neurological symptoms.
Pulsatile tinnitus explained
Hearing your heartbeat in your ear is called pulsatile tinnitus. It is usually caused by turbulent blood flow in vessels near the ear or heightened awareness of normal flow. Common causes include ear infections or earwax (blocking external sounds), high blood pressure, anemia, thyroid overactivity and changes in the carotid artery or jugular vein.
- Idiopathic intracranial hypertension can cause pulsatile tinnitus, mainly in women of reproductive age with obesity.
- Atherosclerosis, arteriovenous malformations and dural fistulas are less common vascular causes.
- Glomus tumors can cause pulsatile tinnitus with a reddish mass behind the eardrum.
When to see a doctor
Evaluation is advised because a treatable vascular cause is found in many cases. Doctors check blood pressure, listen with a stethoscope, test hearing, and may order MRI, MR angiography or CT. Seek emergency care if it comes with sudden hearing loss, weakness, severe headache, vision changes or facial droop. Managing stress, limiting caffeine and treating anemia or high blood pressure may help.
Pulsatile tinnitus explained
Hearing your pulse in the ear is called pulsatile tinnitus. Causes include high blood pressure, anemia, thyroid disease, ear wax, blood vessel abnormalities, narrowing of arteries or pressure disorders such as idiopathic intracranial hypertension. It is sometimes harmless.
When to see a doctor
See a doctor if it lasts or comes with dizziness, hearing loss or headaches. Tests may include imaging. Sudden severe symptoms with neurological signs need emergency care.
Causes of pulse sounds
Pulsatile tinnitus can result from turbulent blood flow near the ear, such as carotid artery narrowing, sigmoid sinus diverticulum, arteriovenous malformations, glomus tumors or idiopathic intracranial hypertension. Anemia, thyroid disease and high blood pressure increase flow. It makes up about 4 percent of tinnitus cases.
Evaluation
An ENT exam, audiogram and imaging such as CT angiography or MRI are used. Treatment depends on the cause: blood pressure control, stenting, surgery or weight loss for IIH. Sound therapy with white noise helps comfort. Seek urgent care for sudden hearing loss, vision changes, severe headache or neurological symptoms.
Based on data from the American Tinnitus Association and the American Academy of Otolaryngology
