Pulsatile tinnitus

Definition: What is pulsatile tinnitus?

If you have a thumping or whooshing sounds in one or both ears that seems to follow a steady beat, you may have this rare form of tinnitus. Unlike regular tinnitus, with the pulsatile form of this condition, the noise comes from inside your body. Your doctor may be able to hear it too, if they listen with a stethoscope. 

How to recognise pulsatile tinnitus

The main symptom of pulsatile tinnitus is hearing a sound in your ears that appears to match your heartbeat or pulse. You may even be able to take your pulse while you’re hearing the sound in your ears. You may also notice heart palpitations or feelings of lightheadedness. You should have these symptoms evaluated by a doctor as soon as possible.

Causes of pulsing sounds

There are many possible causes for the pulsing sound associated with pulsatile tinnitus, but they all stem from circulation issues. Among the most common causes are:

High blood pressure

When your blood pressure rises, the force of blood against the inner walls of your arteries increases.The hearing structures are highly vascularised, with blood vessels supplying oxygen to the cells. This increased force may result in the increased sensation of your pulse. 


Blockage in your arteries caused by a buildup of cholesterol, fats, and waste materials can cause blood flow to be turbulent. If this is the cause, you may hear a rhythmic noise in one of your ears.

Turbulent blood flow

Narrowed neck arteries (carotid arteries) or veins (jugular veins) may also cause a change in blood flow to and from the head. Your ears may pick up on this turbulent or irregular circulation, causing pulsatile tinnitus.

Head or neck tumors

A tumor that presses against a vein can also cause pulsatile tinnitus.

Abnormal capillaries

A problem with the tiny blood vessels that help connect your arteries to your veins, or capillaries, can cause pulsatile tinnitus.
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How to diagnose pulsatile tinnitus

The first step if you think you’re experiencing pulsatile tinnitus is to contact and arrange to see your doctor. Your exam will start with a review of your symptoms and your medical history.

The doctor will probably use a stethoscope to listen to your chest, neck, and skull. If your doctor can also hear a pulsatile noise, you have objective pulsatile tinnitus. If not, it’s labeled as subjective pulsatile tinnitus. You’ll also have hearing tests to determine whether there has been any hearing loss in one or both ears.

Home remedies and treatment

Thankfully, pulsatile tinnitus is often treated by addressing the underlying cause. High blood pressure and vein and artery conditions can usually be treated with a combination of medications and lifestyle changes, including:

  1. A healthy diet 
  2. Regular exercise
  3. No smoking
  4. Stress reduction
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