More than 50 million people experience tinnitus, but it sounds different to everyone. Exploring the causes, signs and treatment options of pulsatile tinnitus can help you better understand how tinnitus impacts hearing health.
Pulsatile tinnitus, also known pulse synchronous tinnitus, is a rhythmic thumping, whooshing or pulsing in the ear. It’s a rare form of tinnitus that tends to be synced to your heartbeat, and can seem as if you’re hearing your heartbeat in your ears. Pulsatile tinnitus can occur in one or both ears, and it can change in pace or tone in relation to changes in your heart rate.
The most common symptom of this type of tinnitus is hearing a steady thumping sound in your ears that occurs without external noise. You might be more likely to hear your heartbeat in your ear when lying down at night, when there are fewer external noises to mask the ear thumping.
Pulsatile tinnitus is a type of tinnitus where the individual hears a rhythmic sound—often described as a whooshing or thumping—that matches the heartbeat. Unlike regular tinnitus, which is typically caused by damage to the auditory system, pulsatile tinnitus is usually linked to blood flow or vascular issues. The most common cause of pulsatile tinnitus is increased blood flow or turbulence in blood vessels near the ear. This can result from conditions such as high blood pressure, atherosclerosis (hardening or narrowing of arteries), or vascular malformations. These conditions may lead to turbulent or amplified blood flow that becomes audible to the individual, especially when lying down or in a quiet environment.
Other possible causes include abnormal connections between arteries and veins (arteriovenous malformations), benign intracranial hypertension, or glomus tumors, which are rare but can affect blood flow near the ear. Unlike other forms of tinnitus, pulsatile tinnitus can sometimes be heard by a doctor using a stethoscope placed near the ear—this is known as “objective tinnitus.” Because pulsatile tinnitus can signal an underlying medical condition, it’s important to consult a healthcare provider for a thorough evaluation and appropriate diagnostic imaging if this symptom occurs.
In most cases, pulsatile tinnitus is caused by changes in blood flow near the ear. The most common causes include:
Unlike regular tinnitus, which is often caused by damage to the inner ear, pulsatile tinnitus is typically vascular in origin and may be treatable, depending on the cause. Because it can sometimes signal a serious underlying condition, it’s important to consult a healthcare provider for proper diagnosis and imaging (such as MRI or CT angiography) if you experience pulsatile tinnitus.
Yes, temporomandibular joint (TMJ) disorders can cause ear-related symptoms such as ringing (tinnitus) and in rare cases, pulsatile tinnitus. The TMJ is located just in front of the ear, and dysfunction in this joint—often due to teeth grinding (bruxism), jaw misalignment, arthritis, or stress—can affect nearby structures, including the ear canal and middle ear.
The most common ear-related symptom of TMJ disorder is non-pulsatile tinnitus, typically experienced as a constant or fluctuating ringing, buzzing, or hissing sound. This may result from muscle tension, nerve irritation, or pressure changes in the ear related to jaw movement.
While pulsatile tinnitus, a rhythmic sound that matches the heartbeat, is usually caused by vascular issues, TMJ dysfunction may indirectly contribute to this symptom in rare cases. This can occur if TMJ inflammation or joint positioning affects nearby blood vessels or nerves, altering blood flow perception.
Other possible ear-related symptoms of TMJ disorder include ear fullness, pressure, or pain, which are sometimes mistaken for ear infections.
If you suspect TMJ as the cause of your tinnitus, consult both a dentist (or TMJ specialist) and an audiologist or ENT. A multidisciplinary approach can help identify the exact cause and guide appropriate treatment options, such as bite guards, physical therapy, or stress management.
Anxiety and stress do not directly cause pulsatile tinnitus, but they can worsen its perception and make existing symptoms more noticeable. Pulsatile tinnitus is typically caused by vascular or structural issues, such as high blood pressure, turbulent blood flow, or abnormalities in blood vessels near the ear.
However, stress and anxiety can heighten awareness of internal body sounds, including the rhythmic whooshing or thumping characteristic of pulsatile tinnitus. In times of anxiety, the body’s “fight or flight” response increases heart rate and blood pressure, which may temporarily intensify vascular sounds. This heightened physiological state can make pulsatile tinnitus more prominent, even if the underlying vascular cause remains the same.
Additionally, people with anxiety may become more hyperaware of bodily sensations, including ear noises, which can lead to a cycle of increased focus, worry, and worsened symptoms.
While stress is not typically a root cause of pulsatile tinnitus, managing anxiety can help reduce its impact. Techniques like mindfulness, cognitive behavioral therapy (CBT), and relaxation exercises can improve coping and reduce the severity of symptoms.
If you experience pulsatile tinnitus, it's important to see a healthcare provider to rule out underlying medical causes and determine the appropriate treatment.
While earwax (cerumen) is not a common cause of pulsatile tinnitus, it can contribute to the perception of internal sounds in certain cases. Pulsatile tinnitus is most often linked to vascular issues, such as turbulent blood flow or high blood pressure, rather than blockages in the outer ear.
However, impacted earwax can block the ear canal, leading to a sensation of fullness, pressure, and changes in how you hear internal bodily sounds—like blood flow or muscle movement. This condition, known as conductive hearing loss, may amplify internal noises, sometimes mimicking pulsatile tinnitus. In such cases, the rhythmic sound may not be due to actual vascular changes, but rather the altered way in which sound is transmitted through a blocked ear canal.
Once the earwax is professionally removed, these symptoms often resolve. If you experience pulsatile tinnitus, especially if it persists after earwax removal, it's important to consult a healthcare provider. True pulsatile tinnitus should be medically evaluated, as it can signal underlying vascular or neurological conditions that may require imaging or further treatment.
Pulsatile tinnitus is not always dangerous, but it can be a sign of an underlying medical condition that requires attention. Unlike regular (non-pulsatile) tinnitus, which is usually caused by hearing loss or noise exposure, pulsatile tinnitus often stems from vascular or structural issues near the ear or brain.
Common causes include:
Some of these conditions can be serious if left untreated. For example, benign intracranial hypertension may lead to vision problems, and vascular malformations can carry a risk of bleeding. That’s why it’s important not to ignore pulsatile tinnitus—especially if it’s new, persistent, or occurs in only one ear.
In many cases, the cause is treatable or manageable once diagnosed. Imaging tests like MRI, MRA, or CT angiography are often recommended to identify the source. If you're experiencing pulsatile tinnitus, consult a doctor—preferably an ENT (ear, nose, and throat specialist) or a neurotologist. While the condition itself may not be harmful, proper evaluation ensures that any potentially serious causes are ruled out or addressed early.
Yes, you can have pulsatile tinnitus in one ear only, and in fact, unilateral pulsatile tinnitus (affecting just one ear) is common and often more concerning than when it occurs in both ears.
Unilateral pulsatile tinnitus may be caused by:
Because pulsatile tinnitus in one ear can indicate an underlying anatomical or vascular issue, it's especially important to seek medical evaluation. Doctors may recommend imaging studies such as an MRI, MRA, or CT angiography to investigate the cause. In some cases, the sound may be linked to muscular causes (e.g. middle ear myoclonus), but a full medical workup is needed to rule out more serious conditions.
If you’re experiencing pulsatile tinnitus in just one ear—especially if it’s new, persistent, or accompanied by hearing changes—consult an ENT specialist or a neurotologist. Early diagnosis can help guide effective treatment or monitoring.
Yes, pulsatile tinnitus can go away on its own in some cases, but this depends on the underlying cause.
If the tinnitus is caused by a temporary condition, such as:
It may resolve without treatment once the underlying issue is addressed or resolves naturally.
However, when pulsatile tinnitus is linked to persistent or structural causes—such as vascular malformations, venous sinus stenosis, or benign intracranial hypertension—it is less likely to go away on its own and may require medical intervention.
Because pulsatile tinnitus is often related to blood flow or pressure changes near the ear or brain, it’s important not to assume it’s harmless. Unilateral (one-sided) pulsatile tinnitus, in particular, should be investigated thoroughly.
If you experience pulsatile tinnitus—especially if it's persistent, one-sided, or accompanied by other symptoms like headaches or vision changes—you should consult a healthcare provider. A proper diagnosis can determine whether the cause is benign, temporary, or potentially more serious, and can guide appropriate treatment or monitoring.
Pulsatile tinnitus can be either constant or intermittent, depending on its underlying cause.
In some people, it is continuous, heard as a steady rhythmic whooshing or pulsing sound in sync with the heartbeat. This is often the case when the tinnitus is related to persistent vascular conditions, such as:
In other cases, pulsatile tinnitus may come and go, appearing during certain activities or body positions. For example:
Intermittent pulsatile tinnitus can also be linked to transient causes, such as:
Regardless of whether it's constant or occasional, pulsatile tinnitus should always be evaluated by a healthcare professional, especially if it's new, persistent, or one-sided. Diagnostic imaging (like MRI or CT angiography) may be needed to identify or rule out serious causes.
Stopping pulsatile tinnitus and ear ringing depends on identifying and treating the underlying cause. Pulsatile tinnitus—a rhythmic sound that matches your heartbeat—is often linked to vascular issues such as high blood pressure, turbulent blood flow, or venous sinus abnormalities. In contrast, constant ear ringing (non-pulsatile tinnitus) is usually related to hearing loss, noise exposure, or inner ear damage.
If you're experiencing pulsatile tinnitus, start by consulting an ENT specialist or audiologist. They may recommend imaging tests like an MRI or CT angiography to check for blood vessel irregularities or tumors. Treating conditions like hypertension, anemia, or vascular malformations can often reduce or eliminate the pulsating sound.
For non-pulsatile ringing, management focuses on reducing the perception of the noise. This may include sound therapy, cognitive behavioral therapy (CBT), hearing aids (if hearing loss is present), or tinnitus retraining therapy.
Stress and anxiety can worsen both types of tinnitus, so relaxation techniques, sleep support, and mindfulness practices may help reduce symptom intensity. Lifestyle changes such as avoiding loud noise, caffeine, and nicotine can also help. In some cases, professional treatment combined with self-care strategies can significantly reduce or resolve tinnitus symptoms over time. Always seek medical advice to determine the safest and most effective treatment.
While health conditions can’t always be prevented, there are a few steps you can take to support and maintain your physical and hearing health. Given the interrelation with the heart health and blood flow, maintaining healthy cholesterol and blood pressure levels may prevent pulsatile tinnitus. A healthy diet and regular exercise are important habits that can improve and support your health now and in the future.
In most cases, pulsatile tinnitus does not require an emergency room visit, but it should be taken seriously. You should consult an ENT specialist or primary care provider as soon as possible, especially if the sound is new, persistent, or only in one ear. These symptoms can be linked to underlying vascular or neurological conditions that may require imaging and further evaluation.
However, go to the emergency room immediately if pulsatile tinnitus is accompanied by sudden hearing loss, a severe headache, vision changes, dizziness, facial weakness, or confusion. These symptoms may indicate a more serious condition, such as a stroke, vascular abnormality, or increased intracranial pressure. While not always dangerous, pulsatile tinnitus can signal treatable issues.
Timely medical evaluation ensures that serious causes are ruled out and appropriate care is started. Don’t ignore new or unusual symptoms—early diagnosis is key.
Pulsatile tinnitus is rarely “nothing,” as it usually has an identifiable cause—often related to blood flow near the ear. Unlike regular tinnitus, which can be idiopathic (without a clear cause), pulsatile tinnitus is typically a symptom of an underlying condition, such as:
In some cases, the cause may be benign and easily treatable, such as temporary earwax buildup or mild changes in blood flow. However, because pulsatile tinnitus can sometimes be linked to more serious vascular or neurological issues, it should never be ignored.
Even if the symptom turns out to be harmless, a proper medical evaluation—often including imaging like an MRI or CT angiography—is important to rule out potentially serious conditions.
In summary, pulsatile tinnitus is rarely without a cause, and seeking medical assessment is the safest approach.
Hearing your heartbeat in your right ear is a symptom known as pulsatile tinnitus. This occurs when you hear a rhythmic sound, often in sync with your pulse. It typically points to blood flow changes or vascular activity near the ear, and it's usually caused by:
Unilateral pulsatile tinnitus (in one ear only) should always be evaluated by a healthcare provider. Imaging tests like MRI or CT angiography may be needed to identify or rule out serious vascular conditions. Early diagnosis is important, especially if the symptom is new, persistent, or worsening.
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