Have you ever heard a sound in your ear that mirrors your heartbeat, almost like a rhythmic whooshing, pulsing, or swishing that just won’t go away? If that sounds familiar, you may be experiencing pulsatile tinnitus, a unique and often misunderstood type of tinnitus that deserves your attention.
While the experience can feel alarming, learning more about this condition is the first step toward finding relief. In this article, we’ll explore what pulsatile tinnitus sounds like, what causes it, how it’s diagnosed, and what treatment options are available whether there’s a known cure or not.
What Is Pulsatile Tinnitus?
Tinnitus is the perception of sound in your ears or head that doesn’t come from an external source. For many people, it presents as a ringing, buzzing, or humming noise. But pulsatile tinnitus is different, it syncs with the rhythm of your heartbeat.
People often describe it as a whooshing, swooshing, or pulsing sound that gets louder in quiet environments. What makes it particularly unique is that it typically has a physical and identifiable cause, unlike other forms of tinnitus.
Common Signs of Pulsatile Tinnitus
If you’re wondering whether the sound you’re experiencing is pulsatile tinnitus, here are some common symptoms:
- A rhythmic sound in one ear in sync with your heartbeat
- Whooshing, swishing, or throbbing noises
- Louder perception in quiet environments or when lying down
- Occasional dizziness, lightheadedness, or headaches
Many individuals live with these symptoms for months or even years, assuming it’s due to stress, earwax, or anxiety. However, there are often underlying medical causes that can and should be evaluated.
8 Common Causes of Pulsatile Tinnitus
Let’s explore the most common causes of pulsatile tinnitus based on current clinical research and audiological findings.
1. Atherosclerosis (Hardening of the Arteries)
Atherosclerosis occurs when fatty deposits build up in your arteries, making them stiff and narrow. This disrupts normal blood flow, causing turbulence that can be heard in the ear—especially if it’s near the temporal bone. This “vascular noise” often results in the pulsing sensation associated with pulsatile tinnitus.
2. Sigmoid Sinus Wall Abnormalities
The sigmoid sinus is a large vein that drains blood from the brain. Abnormalities or dehiscence (thinning or missing bone) in this area can create increased blood flow noise, which is then transmitted to the inner ear, creating a rhythmic whooshing sound.
3. Arteriovenous Malformations (AVMs)
AVMs are abnormal tangles of arteries and veins. If they occur near the auditory pathway, they can disrupt normal blood flow patterns, producing turbulent flow that becomes audible as pulsatile tinnitus.
4. High Blood Pressure (Hypertension)
Elevated blood pressure can cause forceful blood flow, especially through smaller or more vulnerable blood vessels near the ear. This creates a pulsing sound that intensifies with physical activity or stress.
5. Anemia
When your body lacks enough red blood cells, it compensates by increasing cardiac output to deliver oxygen more efficiently. This heightened circulation can generate noise in the ear, particularly near the cochlear or vestibular arteries.
6. Middle Ear Tumors (e.g., Glomus Tumors)
Benign tumors like glomus jugulare or glomus tympanicum are highly vascular and often grow near the middle ear. Blood flow through these tumors can be heard as a pulsing or thumping sound.
7. Idiopathic Intracranial Hypertension (IIH)
Also known as pseudotumor cerebri, IIH is a condition where cerebrospinal fluid pressure around the brain increases without an identifiable cause. The increased pressure can affect nearby blood vessels and result in pulsatile tinnitus.
8. Head Trauma
Head injuries can lead to changes in cerebral blood flow, damage to inner ear structures, or increased intracranial pressure, all of which may result in tinnitus, including the pulsatile type.
How Is Pulsatile Tinnitus Diagnosed?
Diagnosis typically begins with a comprehensive audiological evaluation, which may include:
- Pure-tone hearing test
- Tympanometry
- Imaging studies such as MRI, MRA, or CT scans
- Blood tests to rule out systemic conditions like anemia or thyroid issues
Depending on the suspected cause, you may be referred to an ENT specialist, neurologist, or cardiologist. Working with the right specialists is crucial for identifying the root cause and creating an effective treatment plan.
Treatment Options for Pulsatile Tinnitus
The good news is that many cases of pulsatile tinnitus are treatable once the underlying cause is identified.
Medical and Surgical Treatments
- Vascular issues may be treated with medications, stents, or even surgery
- Benign tumors may require surgical removal
- Hypertension and anemia are typically managed with medication and lifestyle changes
Lifestyle and Dietary Changes
- Reduce salt and caffeine intake
- Practice stress management through mindfulness or exercise
- Avoid loud environments and wear hearing protection when necessary
Sound Therapy and Counseling
If no physical cause is found, or if treatment doesn’t fully resolve the symptoms, there are effective management strategies available:
- Sound therapy with white noise machines or tinnitus maskers
- Cognitive behavioral therapy (CBT)
- Mindfulness and relaxation techniques
As an audiologist, I often support my patients through a combination of education, personalized sound therapy, and coping strategies designed to reduce the emotional impact of tinnitus.
What If There’s No Cure?
In some cases, pulsatile tinnitus persists even after thorough testing. If this happens, it’s important to remember: you are not alone, and you are not helpless.
Supportive therapies and a compassionate care team can help you manage your symptoms and maintain a high quality of life. With time and the right tools, many people find that the sound fades into the background or becomes less distressing.
Final Thoughts
Pulsatile tinnitus may sound frightening at first, but it doesn’t have to control your life. With the right information, a proper diagnosis, and a dedicated team of healthcare professionals, relief is possible.
If you’re hearing a rhythmic sound that matches your heartbeat, don’t ignore it. Trust your instincts, and seek a thorough evaluation. Whether there’s a medical explanation or not, there are effective ways to manage and reduce your symptoms.
Prefer to watch instead? Here’s my quick video on pulsatile tinnitus and treatment options!
