Hearing your heart beat in your ears, often described as a whooshing or thumping sound, is a specific form of tinnitus known as pulsatile tinnitus.
Many people occasionally notice internal body sounds, but when the rhythmic thumping of your heart becomes persistently audible in your ears, it can be quite unsettling. This distinct sensation is not uncommon, and it signals that internal sounds, specifically those from your circulatory system, are becoming perceptible. Understanding why this happens and what it signifies can bring clarity and peace of mind.
What is Pulsatile Tinnitus?
Pulsatile tinnitus presents as a rhythmic sound in one or both ears that synchronizes with your heartbeat. Unlike typical tinnitus, which often manifests as a ringing, buzzing, or hissing sound without a clear rhythm, pulsatile tinnitus has a distinct pulse. You can often confirm its rhythm by checking your own pulse at your wrist or neck.
This sound can be either objective or subjective. Objective pulsatile tinnitus means a doctor might also be able to hear the sound using a stethoscope placed near your ear or neck. Subjective pulsatile tinnitus means only you can hear the sound.
How Does Blood Flow Create Sound?
The human ear is incredibly sensitive, designed to pick up subtle vibrations. Blood flows through a network of vessels, including arteries and veins, very close to the structures of the inner ear. Normally, this flow is smooth and quiet. When blood flow changes in speed, volume, or smoothness, it can create audible vibrations.
These vibrations can be amplified and perceived as sound within the ear. Factors like increased blood pressure, narrowed vessels, or turbulent flow can transform the silent movement of blood into a noticeable thumping or whooshing sound.
Common Causes of Pulsatile Tinnitus
Many conditions can lead to hearing your heartbeat in your ears. These causes generally relate to changes in blood flow near the ear or conditions that amplify internal sounds.
Vascular Conditions
- Atherosclerosis: This condition involves the hardening and narrowing of arteries due to plaque buildup. When arteries near the ear become narrowed, blood flow becomes turbulent, creating a whooshing sound with each heartbeat.
- Arteriovenous Malformations (AVMs): AVMs are abnormal tangles of blood vessels where arteries and veins are directly connected without the usual capillaries in between. This direct connection creates high-pressure, rapid blood flow that can produce a distinct pulsatile sound.
- Venous Hum: This sound originates from turbulent blood flow in large veins, particularly the jugular vein in the neck. Conditions that increase blood flow velocity or volume through these veins can make the hum audible.
- High Blood Pressure (Hypertension): Elevated blood pressure can increase the force and speed of blood flow through vessels. This heightened pressure can make the pulsatile sounds more prominent and noticeable, especially in vessels near the ear.
Ear-Related Issues
- Conductive Hearing Loss: Any condition that causes conductive hearing loss, such as earwax buildup, fluid in the middle ear, or a perforated eardrum, can make internal body sounds, including blood flow, more pronounced. The external sounds are muffled, allowing internal sounds to become more apparent.
- Fluid in the Middle Ear: Accumulation of fluid behind the eardrum, often from infections or allergies, can dampen external sounds. This dampening effect can make the internal sounds of blood flow more audible, similar to how conductive hearing loss operates.
- Glomus Tumors: These are rare, benign, highly vascular tumors that can grow in the middle ear or near the jugular bulb. Their rich blood supply and location can cause a pulsatile sound that synchronizes with the heartbeat.
Other Contributing Factors
Beyond direct vascular or ear issues, other systemic conditions can contribute to pulsatile tinnitus.
- Anemia: A low red blood cell count means the heart must work harder to circulate oxygen-rich blood, increasing blood flow velocity. This faster, more forceful flow can generate sounds that become audible in the ears.
- Hyperthyroidism: An overactive thyroid gland increases the body’s metabolic rate, including heart rate and blood flow. The accelerated circulation can lead to more noticeable pulsatile sounds.
- Idiopathic Intracranial Hypertension (IIH): This condition involves elevated pressure within the skull without an identifiable cause. The increased pressure can affect blood flow in the veins around the brain, potentially leading to pulsatile tinnitus.
- Stress and Anxiety: While not a direct cause, stress and anxiety can heighten one’s perception of internal bodily sensations. They can also affect blood pressure and heart rate, potentially intensifying existing pulsatile sounds or making them more bothersome.
Understanding the potential origins of pulsatile tinnitus is a key first step. The next is recognizing when to seek professional medical advice.
| Sound Description | Potential Cause | Characteristics |
|---|---|---|
| Whooshing, rushing | Artery narrowing (atherosclerosis), AVMs | Often high-pitched, forceful; can be unilateral |
| Thumping, throbbing | High blood pressure, increased cardiac output | Strong, rhythmic; may be bilateral |
| Humming, buzzing | Venous hum, turbulent venous flow | Lower pitched, continuous but pulsatile |
| Clicking, popping | Middle ear muscle spasms, eustachian tube issues | Less common for pulsatile, but can be rhythmic |
When to Seek Professional Guidance
If you consistently hear your heartbeat in your ears, especially if it’s a new symptom, it warrants a conversation with a healthcare provider. This is particularly true if the sound is accompanied by other symptoms, such as dizziness, hearing loss, headaches, changes in vision, or pain.
A medical evaluation helps determine the underlying cause and ensures that any treatable conditions are identified. Early diagnosis can lead to effective management and prevent potential complications. For more information on general ear health, resources from organizations like the National Institute on Deafness and Other Communication Disorders (NIDCD) can be valuable.
| Method | Purpose | What it Involves |
|---|---|---|
| Medical History & Physical Exam | Identify symptoms, risk factors, and listen for objective sounds | Discussion of symptoms, blood pressure check, ear exam, neck auscultation |
| Audiometry | Assess hearing levels | Hearing tests to identify hearing loss or differences between ears |
| Imaging Studies (MRI, MRA, CT, CTA) | Visualize blood vessels and structures near the ear and brain | Detailed scans to detect vascular abnormalities, tumors, or other structural issues |
| Ultrasound (Doppler) | Evaluate blood flow in neck vessels | Non-invasive test to measure blood flow speed and direction in arteries and veins |
Diagnosis and Evaluation
Diagnosing the cause of pulsatile tinnitus typically begins with a thorough medical history and physical examination. Your doctor will ask about the characteristics of the sound, its duration, and any associated symptoms. They may listen to your neck and around your ears with a stethoscope to check for an objective sound.
Further evaluation often involves imaging studies. Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) provide detailed images of blood vessels and soft tissues. Computed Tomography (CT) and Computed Tomography Angiography (CTA) can also visualize bone structures and blood vessels. These scans help identify vascular abnormalities, tumors, or other structural issues near the ear or brain. An audiogram assesses your hearing and can detect any hearing loss that might be contributing to the perception of internal sounds. Sometimes, a Doppler ultrasound of the neck vessels is performed to assess blood flow.
Management and Treatment Options
The approach to managing pulsatile tinnitus depends entirely on its underlying cause. When a specific cause is identified, treating that condition often resolves or significantly reduces the pulsatile sound. For example, if high blood pressure is the culprit, managing it through lifestyle changes and medication can alleviate the tinnitus.
If atherosclerosis is present, treatments aimed at reducing plaque buildup and improving blood flow can be effective. For conditions like AVMs or glomus tumors, surgical intervention or other specialized procedures might be necessary to correct the vascular abnormality. When conductive hearing loss makes internal sounds more prominent, addressing the hearing loss itself, such as removing earwax or treating middle ear fluid, can help. In cases where an underlying cause cannot be fully treated, sound therapy or masking devices can provide relief by introducing external sounds to distract from the pulsatile noise. Lifestyle adjustments, including stress reduction techniques, can also help manage the perception of the sound.
References & Sources
- National Institute on Deafness and Other Communication Disorders (NIDCD). “NIDCD” The NIDCD provides information on hearing, balance, taste, smell, voice, speech, and language.
Mo Maruf
I created WellFizz to bridge the gap between vague wellness advice and actionable solutions. My mission is simple: to decode the research and give you practical tools you can actually use.
Beyond the data, I am a passionate traveler. I believe that stepping away from the screen to explore new environments is essential for mental clarity and physical vitality.