Pulsatile Tinnitus: Hearing Your Heartbeat in Your Ear

What it sounds like

Instead of a steady ringing or hiss, pulsatile tinnitus is a whooshing, thumping or beating sound that follows a rhythm, usually your pulse. You may notice it more when lying down or in a quiet room.

Why it is checked promptly

Most tinnitus is subjective: only the person hears it. Pulsatile tinnitus is different because it is often linked to blood flow near the ear or another physical cause that can be found. Sometimes a doctor can even hear it with a stethoscope. Because a cause can often be identified, and some causes are treatable, it is worth an early medical check.

What a doctor may do

A first appointment usually includes a look in the ears, questions about your medical history and medicines, and a hearing test. You may be referred to an ear, nose and throat specialist, and imaging is more likely to be ordered when tinnitus pulsates.

Signs that need emergency care

• Tinnitus that starts after a head injury.
• Tinnitus with sudden hearing loss.
• Tinnitus with weakness of the face.
• Tinnitus with vertigo, a spinning sensation.

In these cases, seek emergency help and do not drive yourself.

Before the appointment

Note when you hear it, whether it is in one ear or both, whether it changes when you press gently on your neck or turn your head, and any other symptoms. Preparing for a hearing test has a checklist.

Key takeaways

• Pulsatile tinnitus beats in time with your pulse.
• It often has an identifiable cause, so it is checked promptly.
• Expect an ear check, hearing test, and possibly referral and imaging.
• Tinnitus with sudden hearing loss, head injury, facial weakness or vertigo is an emergency.