What causes pulsatile tinnitus and how to treat it?

Symptom Database

Pulsatile tinnitus is a condition characterized by hearing a rhythmic sound in the ears that matches the individual’s heartbeat. Unlike regular tinnitus, which is often described as a constant ringing or buzzing noise, pulsatile tinnitus is more like a rhythmic pulsing or whooshing sound. This condition can be quite distressing and can significantly impact a person’s quality of life. In this article, we will explore the causes of pulsatile tinnitus and discuss various treatment options available.

Understanding Pulsatile Tinnitus

Pulsatile tinnitus is often caused by an underlying problem with blood flow in the body. The sound is typically heard in sync with the individual’s heartbeat, as it is caused by blood circulating through the blood vessels near the ear. This condition can affect one or both ears and may vary in intensity and frequency.

Common Symptoms of Pulsatile Tinnitus

Individuals experiencing pulsatile tinnitus may notice the following symptoms:

  • Rhythmic pulsing or whooshing sound in the ears
  • Sound that matches the heartbeat
  • Intermittent or continuous noise
  • Changes in sound intensity with body position
  • Accompanying symptoms like dizziness or headaches (in some cases)

Causes of Pulsatile Tinnitus

There are several potential causes of pulsatile tinnitus, including:

Vascular Conditions

One of the most common causes of pulsatile tinnitus is a vascular condition. This can include abnormalities in the blood vessels near the ear, such as:

  • High blood pressure
  • Atherosclerosis (narrowing of the arteries)
  • Arteriovenous malformation (abnormal connection between arteries and veins)
  • Turbulent blood flow

Ear and Sinus Issues

Pulsatile tinnitus can also be caused by problems within the ear or sinuses, such as:

  • Ear infections
  • Earwax buildup
  • Eustachian tube dysfunction
  • Sinus congestion

Other Factors

In some cases, pulsatile tinnitus may be associated with other underlying conditions, including:

  • Anemia
  • Thyroid disorders
  • Tumor or growth near the ear
  • Temporomandibular joint (TMJ) disorder

Diagnosing Pulsatile Tinnitus

If you are experiencing symptoms of pulsatile tinnitus, it is important to seek medical attention for a proper diagnosis. Your healthcare provider will likely perform a thorough examination and may order additional tests, such as:

  • Hearing tests
  • Blood tests
  • Imaging studies (MRI or CT scan)
  • Angiography (to evaluate blood vessels)

Treatment Options for Pulsatile Tinnitus

The treatment of pulsatile tinnitus depends on the underlying cause. Once the cause is identified, appropriate treatment options can be explored. Some common treatment approaches include:

Addressing Underlying Medical Conditions

If pulsatile tinnitus is caused by an underlying medical condition, such as high blood pressure or anemia, treating the condition may alleviate the symptoms. This may involve lifestyle changes, medication, or other interventions as recommended by your healthcare provider.

Managing Ear and Sinus Issues

If ear or sinus problems are contributing to pulsatile tinnitus, addressing these issues may provide relief. This can include treatments such as antibiotics for infections, earwax removal, or nasal decongestants for sinus congestion.

Surgical Interventions

In some cases, surgical interventions may be necessary to treat the underlying cause of pulsatile tinnitus. This can include procedures to repair or remove abnormal blood vessels, tumors, or other growths near the ear.

Tinnitus Retraining Therapy

Tinnitus retraining therapy (TRT) is a non-invasive approach that aims to help individuals habituate to the sound of tinnitus. It involves a combination of counseling and sound therapy to reduce the perception of tinnitus and its impact on daily life.

Managing Pulsatile Tinnitus

While there may not be a cure for pulsatile tinnitus in some cases, there are strategies that can help individuals manage the condition and find relief:

  • Avoiding loud noises and excessive noise exposure
  • Using white noise machines or fans to mask the sound
  • Practicing relaxation techniques to reduce stress and anxiety
  • Getting regular exercise and maintaining a healthy lifestyle
  • Seeking support from tinnitus support groups or counseling

It is important to remember that each individual’s experience with pulsatile tinnitus may be unique, and what works for one person may not work for another. It is essential to work closely with healthcare professionals to determine the most appropriate treatment plan for your specific situation.


Pulsatile tinnitus can be a distressing condition, but with proper diagnosis and treatment, relief is possible. By understanding the causes and seeking appropriate medical care, individuals can take steps towards managing their symptoms and improving their quality of life. Remember, if you are experiencing pulsatile tinnitus, consult with a healthcare professional to determine the underlying cause and explore the best treatment options available.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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