Pulsatile Tinnitus – Hearing Your Heartbeat in the Ear
Pulsatile tinnitus is a specific type of tinnitus where the sound you hear is in time with your heartbeat. Patients often describe it as a whooshing, thumping, or pulsing noise in one or both ears.
Unlike common ringing tinnitus, pulsatile tinnitus should always be assessed by an ENT specialist, as it can sometimes be linked to treatable vascular or medical causes.
At Hampshire ENT Clinics, we provide structured, consultant-led assessment of pulsatile tinnitus for patients across Portsmouth, Southampton, Winchester and Salisbury.
👂 What Is Pulsatile Tinnitus?
Pulsatile tinnitus occurs when you become aware of blood flow near the ear or brain.
It may be:
Continuous or intermittent
Present in one ear or both
Worse at night or when lying down
Reduced when pressing on the neck or turning the head
The key feature is that the sound matches your pulse.
🩺 Common Causes of Pulsatile Tinnitus
Pulsatile tinnitus can arise from several different mechanisms, including:
1. Benign Vascular Changes
Increased awareness of normal blood flow
High blood pressure
Anaemia
Pregnancy
Anxiety or stress
2. Venous Causes
Turbulent flow in veins near the ear
Jugular bulb variants
Venous sinus narrowing
These are among the most common causes and are often benign.
3. Arterial Causes
Narrowing of arteries (atherosclerosis)
Carotid artery disease
Abnormal arterial flow patterns
These are less common but important to identify.
4. Middle Ear Conditions
Glomus (paraganglioma) tumours
Middle ear fluid
Abnormal blood vessels behind the eardrum
5. Raised Intracranial Pressure
Sometimes associated with headaches, visual symptoms or obesity.
🚩 When Should Pulsatile Tinnitus Be Checked Urgently?
ENT assessment is recommended if pulsatile tinnitus is:
Persistent
Present in one ear only
Getting worse
Associated with hearing loss
Accompanied by dizziness, headaches or visual disturbance
Associated with a neck lump
New onset with no clear explanation
While serious causes are uncommon, early assessment ensures nothing important is missed.
🔍 How Pulsatile Tinnitus Is Investigated
Assessment at Hampshire ENT Clinics, The Harbour Suite or Medicana Winchester may include:
Detailed history and ENT examination
Examination of the ears and neck
Hearing tests
Blood pressure check
Blood tests (if indicated)
Ultrasound scan of the neck vessels
CT or MRI scanning, including vascular imaging when appropriate
Investigations are tailored to symptoms and findings — not everyone needs all tests.
🛠️ Treatment of Pulsatile Tinnitus
Treatment depends entirely on the underlying cause:
Reassurance where findings are benign
Treating high blood pressure or anaemia
Managing middle ear conditions
Referral to vascular or neurological specialists if required
Monitoring when no concerning cause is identified
In many patients, simply understanding the cause significantly reduces anxiety and symptom awareness.
🌟 Why Choose Hampshire ENT Clinics
Patients choose our service because we offer:
Consultant-led tinnitus assessment
Structured investigation pathways
Access to vascular imaging
Close links with radiology, neurology and vascular teams
Modern facilities
Convenient and rapid access
Care for patients across Portsmouth, Southampton, Winchester and Salisbury
Our priority is reassurance where appropriate and rapid investigation when needed.
👉 If you hear a pulsing sound in your ear that matches your heartbeat, contact Hampshire ENT Clinics or Medicana Winchester for expert assessment.
Frequently Asked Questions (FAQs): Pulsatile Tinnitus
What is pulsatile tinnitus?
Pulsatile tinnitus is a form of tinnitus where the sound you hear is in time with your heartbeat. It is often described as a whooshing, pulsing, or thumping noise, heard in one or both ears.
How is pulsatile tinnitus different from ordinary tinnitus?
Common tinnitus is usually a constant ringing or buzzing sound and is often related to hearing loss. Pulsatile tinnitus is rhythmical and pulse-synchronous, and is more likely to be related to blood flow or medical causes, which is why it requires specialist assessment.
Is pulsatile tinnitus serious?
Most causes are benign and treatable, but pulsatile tinnitus should always be investigated because, in a small number of cases, it can be linked to vascular or neurological conditions.
Why does it sometimes get better when I press on my neck or turn my head?
This suggests a venous cause, where changes in blood flow reduce turbulence near the ear. Venous causes are among the most common and are often reassuring.
Can high blood pressure cause pulsatile tinnitus?
Yes. High blood pressure can increase awareness of blood flow and contribute to pulsatile tinnitus. Treating blood pressure often improves symptoms.
Can pulsatile tinnitus affect just one ear?
Yes. Unilateral (one-sided) pulsatile tinnitus is common and should be assessed, as it may point to a local vascular or middle ear cause.
What conditions can cause pulsatile tinnitus?
Possible causes include:
Benign vascular flow changes
Venous sinus abnormalities
Carotid artery disease (less common)
Middle ear conditions such as glomus tumours
Raised intracranial pressure
Medical conditions such as anaemia or thyroid disease
When should pulsatile tinnitus be checked urgently?
Prompt ENT assessment is advised if it is:
Persistent or worsening
Present in one ear only
Associated with hearing loss
Accompanied by dizziness, headaches, or visual symptoms
Associated with a neck lump
New in onset without explanation
What tests are needed for pulsatile tinnitus?
Not everyone needs the same tests. Assessment may include hearing tests, blood pressure measurement, blood tests, ultrasound of neck vessels, and CT or MRI scans with vascular imaging where appropriate.
Will I definitely need a scan?
Many patients do, but not all. Investigations are tailored to symptoms and examination findings to avoid unnecessary tests while ensuring safety.
Can pulsatile tinnitus be treated?
Yes—treatment depends on the cause. This may include managing blood pressure or anaemia, treating middle ear problems, reassurance for benign venous causes, or referral to specialist teams if required.
Does reassurance alone ever help?
Yes. For many patients, understanding that the cause is benign significantly reduces anxiety and the perceived loudness of symptoms.
Which specialist should assess pulsatile tinnitus?
Pulsatile tinnitus should be assessed by an ENT specialist, often working closely with radiology, neurology, or vascular colleagues when needed.
Where can I be assessed?
Structured, consultant-led assessment is available at Hampshire ENT Clinics and Medicana Winchester, caring for patients from Portsmouth, Southampton, Winchester, Salisbury, and across Hampshire.