People describe pulsatile tinnitus as a thumping that coincides with the heart rhythm. It is a variant of tinnitus — the perception of sound without an external source — and this rhythmic character warrants a separate discussion with a doctor.
What pulsatile tinnitus is
Tinnitus is defined as the perception of sound in the ears or head in the absence of an external acoustic source. Ordinary tinnitus sounds like ringing, humming, hissing, or whistling, whereas pulsatile tinnitus repeats the heart rhythm.
It can be heard in one ear or both, constantly or in episodes. On a severity scale, four grades are distinguished: from tinnitus that one gets used to, to a state in which working capacity is virtually absent.
Why the pulse is heard in the ears
The causes of tinnitus in general are diverse: they include heart and vascular problems, atherosclerosis of the cerebral vessels, cervical osteochondrosis, and pathology of the temporomandibular joint. Tinnitus is also associated with metabolic diseases, such as diabetes mellitus, and with kidney disease. The cause of pulsatile tinnitus specifically is determined by a doctor.
Among the causes mentioned are hearing loss, including age-related, exposure to loud sounds, ear and sinus infections, Ménière's disease, tumors of the head and neck, hormonal changes in women, and thyroid problems. Medications are noted separately: some antibiotics, chemotherapy drugs, high-dose aspirin, and other nonsteroidal anti-inflammatory drugs.
In terms of sound, this comparison is more precise than any description: a pulse in the ear is like a metronome that no one turned on but that sets the rhythm for the whole day.
Tinnitus in one ear: left or right
Pulsatile tinnitus may be felt in the left ear, the right ear, or both.
By duration, acute tinnitus (up to three months), moderate (from three months to a year), and chronic (more than a year) are distinguished.
Pulsation in the ear without pain: what it may mean
Tinnitus is usually not a sign of anything serious and may resolve on its own. However, sound that coincides with the pulse is a reason to make an urgent appointment with a doctor.
How pulsatile tinnitus is evaluated
The doctor examines the ears to rule out what can be treated: infection or cerumen accumulation. Hearing is checked, and if necessary the patient is referred to a specialist for additional tests.
- ear examination and hearing assessment;
- audiometry to determine hearing status;
- videonystagmography;
- consultation with an otorhinolaryngologist and, as indicated, other specialists.
There are no objective indicators of tinnitus severity, so assessment relies on complaints and examination findings.
When to see a doctor
You should see a doctor if the noise is constant or worsening, interferes with sleep, reduces concentration, or causes anxiety or low mood. Pulsatile tinnitus in time with the pulse is a reason for an urgent consultation.
On its own it is not a reason to call an ambulance; 103 or 112 — if tinnitus appeared after a head injury, is accompanied by sudden hearing loss, facial muscle weakness, or a sensation of spinning (dizziness).
This material is for reference: it explains the mechanism and possible causes but does not replace consultation with a doctor.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer