Pulsatile Tinnitus

Pulsatile tinnitus is a rare form of tinnitus. It causes noise in your head that no one else hears. The noise may be a constant whooshing or thumping noise that happens in time with your heartbeat.

What does pulsatile tinnitus sound like?

Pulsatile tinnitus sounds like a rhythmic swooshing or whooshing noise inside of your head that often keeps pace with your pulse. It might sound like a high note from a tuning fork. This is commonly blood pulsing faster than normal through veins and arteries near your ears. In a sense, people who have pulsatile tinnitus hear their hearts beating.

What are the most common causes of pulsatile tinnitus?

Conditions that may cause pulsatile tinnitus include:

• Anemia that increases your blood flow and the amount of noise in your head
• Arteriovenous malformations that create tangles of blood vessels near your ears
• Atherosclerosis that causes uneven blood flow, so your blood makes more noise as it flows through arteries close to your ears
• Head injuries that affect veins and arteries near your ears
• High blood pressure (hypertension) that puts pressure on your blood vessel walls
• Hyperthyroidism, which may make your heart speed up and boost blood flow
• Idiopathic intracranial hypertension that causes cerebrospinal fluid to build up around your brain and put pressure on your blood vessels
• Paget’s disease that can lead to increased blood flow in your skull and temporal bone
• Sinus wall abnormalities (SWAA) that increase blood flow through your sinus wall (a channel on the side of your brain that receives blood from veins in your brain)

How is pulsatile tinnitus treated?

Healthcare providers treat pulsatile tinnitus by identifying and treating the underlying condition. If you have atherosclerosis, for example, your provider may use medication to manage your condition. The medication may eliminate or reduce the swooshing sound of your heart beating in your ear.

There are also some things you can do to reduce the impact that pulsatile tinnitus can have. Does pulsatile tinnitus seem louder and more annoying when you’re ready for bed or in a quiet place? Consider using a white noise machine to mask the noise in your head. Other options are running a fan or playing soft music.

Other steps to consider are:

• Cognitive behavioral therapy or acceptance and commitment therapy, which may help you manage the impact that pulsatile tinnitus has on your life
• Stress management techniques to ease stress that can make your symptoms worse

What are the possible complications or risks of not treating pulsatile tinnitus?

Pulsatile tinnitus often is a symptom of an underlying health issue. Getting help may lead to treatment for a serious illness. Some people who have pulsatile tinnitus develop depression or anxiety. Ask your provider about ways you can reduce the impact this symptom may have on your well-being.

When should I go to the emergency room?

Go to the emergency room or get help right away if you:

• Suddenly hear a rhythmic swooshing sound in your head
• Hear that sound in just one ear
• Have pulsatile tinnitus and other issues, like difficulty with balance or vision