What is Pulsatile Tinnitus?



Pulsatile tinnitus is a condition that affects many individuals around the world, and understanding the symptoms, causes, and treatment options can help people manage their condition better. This article will explore various topics related to pulsatile tinnitus, such as understanding the disorder, diagnosing it, identifying potential causes and risk factors, available treatments, and coping strategies and support.

Pulsatile tinnitus is a relatively uncommon form of tinnitus that can be very distressing for those who experience it. Understanding its causes and symptoms is essential for effective diagnosis and treatment.


The difference between pulsatile tinnitus and tinnitus

While both pulsatile tinnitus and regular tinnitus involve the perception of sounds that are not present in the surrounding environment, they have different characteristics. Pulsatile tinnitus is typically caused by issues with blood flow or vascular malformations, whereas regular tinnitus is often linked to hearing loss, exposure to loud noises, or other factors affecting the auditory system.


Furthermore, pulsatile tinnitus has a rhythmic, pulsing quality that correlates with the person's heartbeat, making it easier to differentiate from the constant ringing or buzzing of regular tinnitus. People with pulsatile tinnitus may find that the noise is more noticeable when they are lying down or when their heart rate is elevated.


If you are experiencing pulsatile tinnitus or any other type of tinnitus, it is important to seek medical advice. A doctor can help you determine the cause of your symptoms and recommend appropriate treatment options. With the right care, it is possible to manage tinnitus and improve your quality of life.

Symptoms of pulsatile tinnitus

Pulsatile tinnitus is a type of tinnitus characterised by rhythmic, whooshing, or pulsating sounds that are in sync with the person's heartbeat. The noise can be heard in one or both ears and can range from barely noticeable to incredibly loud and disruptive.


People with pulsatile tinnitus may describe the sound as a thumping, pulsing, or fluttering sensation in their ears. The noise may be continuous or intermittent, and its intensity can vary over time. Some people may also experience dizziness, headaches, or other symptoms alongside their pulsatile tinnitus.


It is essential to note that pulsatile tinnitus is different from regular tinnitus, which is typically described as a constant ringing or buzzing sound in the ears.

Pulsatile tinnitus causes

There are several potential causes for pulsatile tinnitus, with the most common being related to the blood vessels near the ear. Blood flow disturbances or abnormalities in the blood vessels can produce pulsatile tinnitus symptoms. For example, atherosclerosis, a condition where the arteries become narrow and hardened, can lead to pulsatile tinnitus.


Other potential causes of pulsatile tinnitus include:

  • Ear infections
  • High blood pressure
  • Tumors or lesions in the head or neck
  • Malformation of the capillaries or veins in the ear
  • Anemia
  • Thyroid problems
  • Stress or anxiety
  • Medications that affect blood flow

It is essential to understand that pulsatile tinnitus can sometimes be a symptom of an underlying health condition, making it crucial for affected individuals to seek medical advice. A doctor can perform tests to determine the cause of the pulsatile tinnitus and recommend appropriate treatment.

How to diagnose and treat pulsatile tinnitus?

In this section, we will explore the methods used for diagnosing pulsatile tinnitus, such as medical history and physical examinations, imaging techniques, and audiometric testing.

Medical History and Physical Examination

The first step in diagnosing pulsatile tinnitus involves a thorough medical history and physical examination. The doctor will ask the patient about their symptoms, potential triggers, and any personal or family history of tinnitus or other hearing issues. Additionally, the physician may inspect the ear visually and use a stethoscope to listen for any abnormalities in blood flow.

Imaging Techniques

Imaging techniques like CT scans, MRIs, and ultrasound can help identify the cause of pulsatile tinnitus, such as blood vessel abnormalities or tumors. These imaging tools are instrumental in visualizing the structures within and around the ears, allowing doctors to rule out or confirm potential causes of the condition.

Audiometric Testing

Audiometric testing is another method used to assess a patient's hearing abilities and possible contributing factors to pulsatile tinnitus. During an audiogram, various sounds are transmitted to the patient through headphones, and they indicate when they hear each sound. This information, along with other diagnostic tools, can help the physician identify the cause of the pulsatile tinnitus and develop an appropriate treatment plan.


Causes and Risk Factors

In this section, we will discuss some of the primary causes and risk factors for pulsatile tinnitus, including vascular abnormalities, high blood pressure, tumors and lesions, ear infections and inflammation, and lifestyle factors.


Vascular Abnormalities

The most common cause of pulsatile tinnitus is vascular abnormalities, such as abnormal blood vessels or changes in blood flow close to the ear. Conditions like arteriovenous malformations, carotid artery disease, and vein abnormalities can contribute to pulsatile tinnitus symptoms.


High Blood Pressure

High blood pressure, or hypertension, can sometimes be a cause of pulsatile tinnitus. Elevated blood pressure can result in increased or turbulent blood flow, which can produce sounds that the affected individual perceives as pulsatile tinnitus.


Tumors and Lesions

In some cases, tumors and lesions near the ear or within the auditory system can lead to pulsatile tinnitus. These growths may affect blood flow or nerve function, resulting in the characteristic symptoms of this condition.


Ear Infections and Inflammation

Ear infections and inflammation can also contribute to the development of pulsatile tinnitus. Infections can lead to increased fluid levels in the ear, putting pressure on the eardrum and affecting blood flow, leading to pulsatile tinnitus symptoms.


Lifestyle Factors

Some lifestyle factors may put individuals at risk for pulsatile tinnitus, such as smoking, obesity, and exposure to loud noises. These factors can contribute to high blood pressure, vascular abnormalities, or hearing problems that can result in pulsatile tinnitus.


Treatment Options for Pulsatile Tinnitus

This section will discuss the various treatment options available for pulsatile tinnitus, such as addressing the underlying cause, medications, surgical interventions, and sound therapy and tinnitus retraining therapy.


Addressing the Underlying Cause

The most effective way to treat pulsatile tinnitus is to address the underlying cause of the condition. This may involve lifestyle changes, such as improving diet and exercise habits, quitting smoking, or managing stress. For some patients, treating the cause may completely resolve their symptoms.



In some cases, medications may be prescribed to help manage pulsatile tinnitus symptoms or treat the underlying cause. For example, antihypertensive medications can be used to lower blood pressure, while diuretics can help reduce fluid levels in the ear.


Surgical Interventions

Depending on the cause of pulsatile tinnitus, surgical interventions may be necessary to treat the condition. This could involve removing tumors or repairing damaged blood vessels that are contributing to the symptoms.


Sound Therapy and Tinnitus Retraining Therapy

Some individuals with pulsatile tinnitus may benefit from sound therapy or tinnitus retraining therapy. Sound therapy utilizes external sounds or music to help mask the tinnitus, while tinnitus retraining therapy involves teaching patients to ignore their symptoms and shift their focus away from the noise.


Coping Strategies and Support

In this section, we will discuss coping strategies and support options for individuals experiencing pulsatile tinnitus, such as lifestyle changes, stress management and relaxation techniques, and support groups and counseling.


Lifestyle Changes

Making certain lifestyle changes can help alleviate the symptoms or reduce the risk of developing pulsatile tinnitus. These may include maintaining a healthy weight, quitting smoking, reducing exposure to loud noises, and engaging in regular exercise.


Stress Management and Relaxation Techniques

Stress can exacerbate pulsatile tinnitus symptoms, so finding effective stress management and relaxation techniques is essential for those affected by the condition. Methods such as mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help individuals cope with stress and reduce tinnitus symptoms.


Support Groups and Counselling

For some individuals, joining a support group or seeking counseling can help them better manage their pulsatile tinnitus symptoms. Support groups offer a safe space for people to share their experiences and learn from others dealing with similar challenges, while counseling can provide targeted help in coping with the emotional and practical aspects of the condition.


Book a FREE hearing check up

If you are concerned about your hearing, contact us as soon as possible to book a free hearing test and talk to our audiologists about your experiences.

Hidden Hearing is Ireland’s leading private provider of hearing care solutions, and our national network includes over 80 and clinics. We have an excellent variety of hearing aids, including small and highly sensitive models that are invisible to other people, and you can try these when you visit your clinic.



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Written by: Sarah Sheehan, Chief Audiologist, ISHAA Member
Sarah Sheehan is an esteemed member of our HR, L&D and Compliance Department, who joined Hidden Hearing in 2018 as an audiologist. Sarah’s career has seen her work in a wide range of areas within the company and she is committed to providing education about audiology and keeping abreast of current audiology trends.
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