What Is Pulsatile Tinnitus?
Pulsatile tinnitus is a condition where individuals hear a rhythmic sound, often resembling a heartbeat, in their ears without any external noise source. While temporary cases may arise from fatigue or intense physical activity, persistent occurrences could indicate underlying health conditions.
This article explores five possible causes of pulsatile tinnitus. Some cases resolve on their own, but others require medical intervention. If symptoms persist, consulting a healthcare provider is recommended.
1. Otitis Media with Effusion (OME)
The middle ear, located behind the eardrum, can accumulate fluid due to inflammation, a condition known as otitis media with effusion (OME). This trapped fluid can lead to a humming or pulsating sound in the ear, especially when swallowing or yawning. While it is not typically painful, untreated cases may result in hearing loss.
2. External Ear Canal Inflammation (Otitis Externa)
Another possible cause of pulsatile tinnitus is otitis externa, an inflammation of the external ear canal caused by bacterial infections. Individuals may experience a sensation of ear fullness or muffled hearing. Itchy ears, swelling, and discharge may also occur in severe cases. Factors such as frequent swimming, excessive earwax buildup, and immune system deficiencies can contribute to this condition.
3. Upper Respiratory Infections (URI)
Inflammation in the upper respiratory tract, including the nasal passages, throat, and larynx, can also lead to pulsatile tinnitus. Symptoms such as nasal congestion, a runny nose, swollen tonsils, fever, and cough may accompany the condition. The most common cause of upper respiratory infections is the common cold, which typically resolves within a few days with adequate rest and hydration.
4. Vestibular Schwannoma (Acoustic Neuroma)
In some cases, pulsatile tinnitus can be a symptom of vestibular schwannoma, a benign tumor on the nerve responsible for hearing and balance. Early symptoms include hearing loss, mild dizziness, and a rhythmic sound in the ear. As the tumor grows, it may compress facial nerves, leading to facial numbness or weakness. Prompt medical evaluation is necessary to prevent complications.
5. Other Underlying Conditions
Various medical conditions can cause pulsatile tinnitus, including:
- Temporomandibular Joint (TMJ) Dysfunction – Jaw joint problems can lead to ear-related symptoms.
- Anemia or Hyperthyroidism – Increased blood flow near the ear can result in a pulsing noise.
- Atherosclerosis or Hypertension – Circulatory issues affecting the ear’s blood vessels can amplify sounds.
- Intense Physical Activity or Pregnancy – Temporary increases in blood flow may cause pulsatile tinnitus.
What to Do If You Hear a Heartbeat in Your Ear
If you experience pulsatile tinnitus, start by resting and observing if the symptoms subside. Persistent cases should be evaluated by an ear, nose, and throat (ENT) specialist. To assist in diagnosis, inform your doctor about additional symptoms such as pain, dizziness, nasal congestion, or facial numbness.
Pulsatile tinnitus can present in various forms, including buzzing, wind-like noises, or a blocked ear sensation. Among them, hearing a heartbeat-like sound often correlates with increased blood flow near the ear. Checking whether the sound synchronizes with your pulse can provide valuable diagnostic insight.