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Pulsatile tinnitus is caused by blood circulating in or near your ears.
Unlike most types of tinnitus, pulsatile tinnitus has a physical source of sound that your ears pick up. It’s an amplified sound of blood circulating through your arteries.
The ringing or buzzing you hear with other kinds of tinnitus is a result of nerves picking up on abnormal electrical signals moving from your ears to your brain.
The main symptom of pulsatile tinnitus is hearing a sound in your ears that seems to match your heartbeat or pulse. You may even be able to take your pulse while you’re hearing the sound in your ears.
You may also notice heart palpitations or feelings of lightheadedness. You should have these symptoms evaluated by a doctor as soon as possible. If you experience sudden chest pain or other signs of a heart attack, call 911.
There are many possible causes of pulsatile tinnitus, but they all stem from circulation issues. Among the most common causes are:
When your blood pressure rises, the force of blood against the inner walls of your arteries increases. More forceful blood flow in arteries in or around the ears is easier for your ears to detect.
Blockage in your arteries caused by a buildup of cholesterol, fats, and waste materials can cause blood flow to be turbulent. If this is the cause, you may hear a rhythmic noise in one of your ears.
Turbulent blood flow
Narrowed neck arteries (carotid arteries) or veins (jugular veins) may also cause a change in blood flow to and from the head. Your ears may pick up on this turbulent or irregular circulation, causing pulsatile tinnitus.
Head or neck tumors
A tumor that presses against a vein can also cause pulsatile tinnitus.
A problem with the tiny blood vessels that help connect your arteries to your veins, or capillaries, can cause pulsatile tinnitus.
Make an appointment with your doctor if you think you’re experiencing pulsatile tinnitus. Your exam will start with a review of your symptoms and your medical history.
The doctor will probably use a stethoscope to listen to your chest, neck, and skull. If your doctor can also hear a pulsatile noise, you have objective pulsatile tinnitus. If not, it’s labeled as subjective pulsatile tinnitus.
You’ll also have hearing tests to determine whether there has been any hearing loss in one or both ears. Your doctor may order some imaging tests as well. These include:
You may also be tested for high blood pressure and given a blood test to check for thyroid disease or anemia.
If it appears as though you have pulsatile tinnitus, you may be referred to a cardiologist (heart specialist) for an exam and screenings for possible circulation problems or high blood pressure.
Pulsatile tinnitus can cause sleeping problems. Poor sleep can lead to:
- difficulty with concentration
- low energy
- cardiovascular problems
- weight gain and other metabolism issues
Pulsatile tinnitus is often treated by addressing the underlying cause.
High blood pressure and vein and artery conditions can usually be treated with a combination of medications and lifestyle changes, including:
- a low-sodium diet
- regular exercise
- no smoking
- stress reduction
If the cause relates to a specific problem in an artery or vein, surgery or a catheter procedure may be needed to treat the condition. A flexible mesh tube, called a stent, is sometimes placed in a blocked artery to open it up and improve blood flow.
If the blood vessel can’t be treated, you may benefit from sound therapy. This involves playing background noise, such as soft music or “white noise,” to distract you from the tinnitus or change your brain’s sensitivity to the pitch of the tinnitus. You may also benefit from cognitive behavior therapy, a form of talk therapy designed to change the way you think about a problem in order to change your emotional reaction to it and the way you behave toward it.
The outlook for pulsatile tinnitus depends on the underlying cause. Most of the conditions that cause pulsatile tinnitus can be treated with medication and lifestyle changes.