Pulsating in Ear

A pulsing sound in the ear feels like your heart is beating in your ear. It can affect one or both ears. In the medical community, a pulsating sensation in the ear is called pulsatile tinnitus/vascular tinnitus.

Pulsating in ear symptoms include the following:

• The patient feels and hears a heart-pulsing sound in the ears.
• The sound in the ear is sometimes described as swirling, swishing, or beating.
• Sometimes patient complains of ear pain. ^{(1, 2, 3)}

 

Image 1: An anatomical presentation of the human ear
Picture Source: www.tinnitusformula.com

What causes pulsations (heartbeat noise) in the ear?

A pulsing sensation in the ear can cause discomfort and sometimes pain depending on the severity of the condition.

Benign intracranial hypertension

A pulsating feeling in the ear can be a signal of an underlying serious medical condition such as the BIH. It is a result of the rise of cerebrospinal fluid pressure. It commonly affects young and overweight female. Aside from pulsating in the ear, other symptoms to watch out for are:

1. A feeling of fullness in the ear
2. Dizziness
3. Visual disturbances ⁽⁴⁾
4. Headache
5. Hearing loss ⁽³⁾

Atherosclerotic carotid artery disease

The arteries narrow secondary to the buildup of cholesterol on the arterial wall. It restricts the flow of blood and causes turbulence leading to pulsatile sensation in the ear. This is the leading cause of pulsating in the ear in geriatric patients, especially those who have high cholesterol in the blood, hypertension, and diabetes mellitus. ^{(5, 6)}

Glomus tumor

It is a benign tumor in the ear or right below the ear. To get rid of the swishing sound in the ear and prevent further complication, the tumor should be surgically removed. ⁽⁶⁾

Intracranial vascular lesions

It is the abnormal connection between the vein and the artery leading to an improper flow of blood. The blood bypasses the capillaries and goes directly into the artery. If the pulsating in the ear is extremely bothersome and has been going on for a long period of time, you need to have it checked as it could be caused by intracranial vascular lesions. It could potentially lead to an aneurysm, which is an extremely dangerous situation. ^{(5, 6)}

Middle ear effusion

The middle part of the air is filled with air. However, if there is an infection, fluid accumulates the ear leading to dysfunction of the Eustachian tube. This results in a pulsating sensation in the ear. Other notable symptoms include pain, a feeling of fullness in the ear and decreased hearing. ^{(4, 7)}

High blood pressure

Pulsating in the ear is commonly experienced by people with high blood pressure. They usually felt it a few minutes after taking blood pressure medication.

Venous Hum

It is the increase the flow of blood through the jugular vein, which is the largest vein in the neck. The very same vein transverses the middle ear, which causes blood flow turbulence, which is detected in the ear. It’s more like a humming sound. This is most likely to happen in pregnant women as well as those having blood and thyroid problems. ^{(7, 8)}

Twisted arteries

If there is a problem in the arteries such as in the case of twisted arteries, the flow of blood is altered leading to turbulence and this can be felt in the ears.

Anxiety

Pulsating in the ear can also occur in people who are in a great deal of stress and anxiety.

A pulsing sound in the ear is caused by a variety of factors. Some of them are mild and go away on their own while others possess a serious risk and require immediate medical attention. To accurately diagnose the condition of the patient, various tests and medical procedures need to be done. They are the following:

1. MRI (Magnetic Resonance Imaging) – It is a diagnostic procedure that captures images of the inside structure of the arteries and veins.
2. CT scan (Computerized tomography) – A detailed image of the body is captured via a computer controlled x-ray.
3. Angiography – A contrast medium is injected into the vessel to visualize the inside structure of the blood vessel.
4. Blood work – The doctor will order for a complete blood count to rule out underlying medical condition such as anemia and thyroid abnormalities.
5. Thyroid function test – If the doctor is suspecting an overactive thyroid, he will order for a thyroid function test.
6. Neurologic and ophthalmologic investigations – These are performed if the doctor is suspecting for intracranial hypertension. ^{(3, 6, 9, 10)}

How to stop pulsing in the ear?

Photo 2: A Valsalva maneuver is one of the clinical methods used to get rid of pulsating sensation in the ear.
Picture Source : www.valsalva.org

There are many different ways to stop the pulsating sensation in the ears. For some reasons, the pulsating feeling in the ear goes away on its own. However, if it is caused by a serious underlying medical condition, then medical interventions are necessary. These include the following:

• If the pulsating feeling in the ear is caused by turbulent blood flow in the arteries, pressure should be applied to the upper neck to significantly reduce the pulsing sound.
• If the problem has something to do with the veins, then it can be improved significantly with the help of Valsalva maneuver.
• For causative factors like anemia, the pulsing sound in the ear can be improved over time with the help of blood medication and transfusion. Those patients with high blood pressure can be treated using blood pressure lowering medications.
• If the pulsing sound in the ear is secondary to tumor, then the tumor needs to be surgically removed. For slow-growing benign tumor, the doctors prefer not to remove it to avoid further complications. What they do is they come up with other measures to somehow reduce the pulsing sensation in the ears. These methods include relaxation therapy, sound therapy, meditation, cognitive behavioral therapy, and tinnitus retraining therapy.

If you are experiencing a pulsing sound and swishing sensation in one or both ears, then you need to have it checked by your doctor. By doing so, worsening of the condition can be removed significantly. ^{(2, 5, 8, 10)}

References:

1. https://www.tinnitusformula.com/library/pulsatile-tinnitus-2/
2. http://www.anxietycentre.com/anxiety/symptoms/pulsing-in-the-ear.shtml
3. http://american-hearing.org/disorders/tinnitus/
4. https://www.webmd.com/healthy-aging/aging-pulsatile-tinnitus
5. https://www.healthline.com/health/pulsatile-tinnitus
6. https://www.medicalnewstoday.com/articles/319494.php
7. https://www.tinnitus.org.uk/pulsatile-tinnitus
8. https://www.hear-it.org/tinnitus-in-the-blood
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719451/
10. https://www.dizziness-and-balance.com/disorders/hearing/tinnitus/pulsatile.html