Pulsatile tinnitus: Causes, symptoms, and what you can do
Pulsatile tinnitus: Causes, symptoms, and what you can do
9 min.
Publication Date: March 21, 2021
Article Updated: January 22, 2026
Pulsatile tinnitus is a rare and rhythmic form of tinnitus that typically follows the sound of your heartbeat. Unlike traditional tinnitus—which may be described as ringing, static, or buzzing—pulsatile tinnitus often sounds like whooshing, thumping, or throbbing in the ear.
For most people, it occurs in just one ear and is especially noticeable in quiet environments. While the condition itself is not usually harmful, it can sometimes point to an underlying vascular or neurological issue. This makes medical assessment an important first step.
Note: Our Hearing Care Providers (HCPs) are here to support your hearing health and provide personalized guidance. However, if you're concerned about medical issues affecting your hearing, always consult your healthcare provider first.
What is pulsatile tinnitus?
Pulsatile tinnitus is a type of tinnitus where the perceived sound is rhythmic and often matches the beat of your pulse. This sound typically comes from changes in blood flow near the ear, which your auditory system interprets as internal noise.
Unlike classic tinnitus, which is often continuous and high-pitched, pulsatile tinnitus can come and go depending on your activity level, stress, or blood pressure. It’s more likely to be linked to an underlying medical condition, making early evaluation worthwhile.
What are the symptoms of pulsatile tinnitus?
The most distinctive symptom is hearing a pulsing sound that matches your heartbeat. However, people may describe it differently based on how it presents. Common symptoms include:
A rhythmic pulsing, thumping, or whooshing in one or both ears
A sensation of fullness or pressure in the ear
A sound that becomes more noticeable in quiet settings or at night
Increased intensity during or after physical activity
Occasional headaches or visual changes (in some cases)
Because these symptoms can overlap with other conditions, it’s important to keep track of what you notice and when—and share those details with a healthcare provider.
What causes pulsatile tinnitus?
Pulsatile tinnitus is most often caused by changes in blood flow or increased awareness of blood moving through vessels near the ear. These changes may be linked to specific health conditions or structural abnormalities.
Common causes include high blood pressure, atherosclerosis (narrowed arteries), anemia, hyperthyroidism, vascular tumors, or abnormalities in the shape or function of blood vessels.
Pulsatile tinnitus is also associated with increased intracranial pressure or conditions that amplify internal body sounds, like ear infections or impacted earwax. But if no clear cause is found, in some cases symptoms can still be managed with lifestyle adjustments and therapy.
How is pulsatile tinnitus diagnosed?
Your healthcare provider will begin with a detailed review of your symptoms and a physical exam of the ears, head, and neck. They may listen to your neck or skull with a stethoscope to determine whether the sound is audible to others. You may also be referred for additional tests, including:
Hearing tests to assess your baseline auditory function.
Imaging studies (MRI, CT scan) to evaluate soft tissue and vascular structures.
Blood tests to screen for thyroid issues, anemia, or inflammation.
Ultrasounds or angiograms to study blood vessel flow.
These tests help identify whether pulsatile tinnitus is due to a structural or circulatory issue and reveal what your next steps should be.
How is pulsatile tinnitus treated?
If your pulsatile tinnitus is caused by a medical condition like high blood pressure, anemia, or a vascular issue, treatment often focuses on managing that condition. This might include medication, dietary changes, or increased physical activity to support better circulation.
In cases where no specific cause is found, the focus shifts to management strategies that can help reduce the impact of the sound. These may include sound therapy, cognitive behavioural therapy (CBT), or tinnitus retraining therapy (TRT) to help your brain adapt and tune out the noise over time.
Some people also find relief through mindfulness, relaxation techniques, and stress reduction, especially if their symptoms fluctuate with anxiety or fatigue.
Frequently asked questions about pulsatile tinnitus
Pulsatile tinnitus can raise a lot of questions, especially if it’s new or intermittent. Here are a few of the most common things people ask.
Can pulsatile tinnitus be dangerous?
Pulsatile tinnitus itself is not usually dangerous. However, because it can sometimes be linked to vascular or circulatory conditions, it’s important to have it assessed by your primary healthcare provider—especially if it appears suddenly, worsens over time, or is accompanied by headaches or vision changes.
Does pulsatile tinnitus go away on its own?
Pulsatile tinnitus caused by temporary factors—such as exercise, stress, or short-term changes in blood pressure—may resolve once the body returns to its normal state. If symptoms persist or return frequently, it’s a good idea to seek medical advice.
Is there a link between pulsatile tinnitus and anxiety?
Anxiety does not directly cause pulsatile tinnitus, but it can make symptoms more noticeable or distressing. Managing stress can often help reduce how disruptive pulsatile tinnitus is day to day.
Can pulsatile tinnitus be cured?
If an underlying cause is identified and successfully treated, pulsatile tinnitus may resolve completely. When no specific cause is found, treatment focuses on managing symptoms and reducing their impact.
Is pulsatile tinnitus hereditary?
Pulsatile tinnitus is more commonly associated with circulatory or structural issues rather than heredity factors. Environmental and health-related factors tend to play a larger role.
Can pulsatile tinnitus be intermittent?
Pulsatile tinnitus can come and go, especially if it’s influenced by changes in blood pressure, physical activity, stress levels, or body position. Keeping track of when symptoms occur can help your healthcare provider identify patterns and potential triggers.
Understanding your next steps
If you’ve started to notice pulsing or heartbeat-like sounds in your ears—especially if they’re new, worsening, or affecting your quality of life—it’s time to check in with your healthcare provider. Even if your hearing seems normal, the symptoms could point to something that needs further investigation.
Key takeaways
Pulsatile tinnitus is rhythmic and often linked to blood flow.
It’s more likely than standard tinnitus to have an identifiable medical cause.
Symptoms may include pressure, fullness, or heartbeat-like pulsing in the ear.
Diagnosis may involve hearing tests, imaging, and bloodwork.
Treatment depends on the cause, but many people benefit from sound therapy, CBT, or medical care.
Always seek medical evaluation if symptoms are persistent, unusual, or accompanied by other changes.
Book a free hearing test or find a clinic near you to take the first step toward relief and peace of mind.