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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can assess pulsatile tinnitus by video and arrange the tests; finding and treating the cause happens in person.
- What it is: a rhythmic whooshing or thumping in one or both ears that keeps time with your heartbeat. You can check by feeling your pulse while you listen.
- How common: pulsatile tinnitus is rare, but tinnitus of any kind affects an estimated 10 to 25% of adults; the pulsing kind is the one that needs tests for a cause.
- Why it matters: unlike ordinary tinnitus, it often has a physical cause, such as anaemia, an overactive thyroid, high blood pressure or a blood vessel problem, so it always needs assessing.
- How soon: tinnitus that beats in time with your pulse needs an urgent appointment with a doctor, even if you feel well.
- Emergency: call 112 for pulsatile tinnitus with a sudden severe headache, facial drooping, weakness, slurred speech or loss of vision, or after a head injury.
Do not book a video appointment if the sound came with a sudden severe headache, facial drooping, weakness, numbness, slurred speech, double vision or loss of vision, confusion, or after a head injury: call 112 or go to an emergency department. If it started suddenly, or comes with headaches and blurred vision, sudden hearing loss or problems with balance, get medical advice the same day.
Can an online doctor help with pulsatile tinnitus?
Partly. Pulsatile tinnitus always needs its cause looked for, and that takes tests in person: a blood pressure check, blood tests, an examination of the ears, neck and heart, a hearing test and often a scan. What a doctor can do by video is confirm that the sound really keeps time with your pulse, check for the signs that need emergency care, work out the likely causes from your story, and tell you which tests you need, how soon and where to get them.
How an online consultation helps with pulsatile tinnitus
- Is it really pulsatile?: Whether the sound keeps time with your pulse, or is a clicking or ordinary ringing with a different cause.
- Emergencies ruled out first: A sudden severe headache, stroke signs, vision changes or a head injury mean care in person, straight away.
- The likely causes: Anaemia, thyroid, blood pressure, the ear itself or a blood vessel problem, worked out from your story.
- The right tests, in the right order: Which checks come first, which specialist to see, and how urgently.
What the doctor checks in an online pulsatile tinnitus consultation
The doctor asks about the warning signs first, then about the sound itself. The doctor asks about:
- Warning signs: a sudden severe headache, facial weakness, slurred speech, double vision, loss of vision, confusion, a recent head injury, or new problems with balance.
- The sound: whooshing, thumping or clicking, whether it keeps time with your pulse, one ear or both, and whether it is constant.
- What changes it: exercise, lying down, turning or pressing on the neck, and quiet rooms.
- Your ears: hearing loss, a blocked feeling, discharge, and earlier ear problems.
- Your health: headaches with blurred vision, tiredness or breathlessness, weight loss, palpitations, pregnancy, high blood pressure, and your medicines.
Before the call, sit somewhere quiet, feel your pulse at your wrist or neck, and check whether the sound beats with it. If you have a home blood pressure monitor, take a reading.
What is pulsatile tinnitus?
Pulsatile tinnitus is a rhythmic noise in the head or ears, usually a whooshing, swooshing or thumping, that keeps time with your heartbeat. It is a rare form of tinnitus: most tinnitus is a steady ringing, buzzing or hissing that only you can hear, and surveys estimate that 10 to 25% of adults have tinnitus of some kind.
Pulsatile tinnitus is different because it is often the sound of blood flowing through vessels near the ear. In some people a doctor can even hear it through a stethoscope, which is called objective tinnitus. That is why it often has a cause that can be found and treated.
What is mistaken for pulsatile tinnitus?
Other sounds can be rhythmic without keeping time with the pulse. Occasional clicking or machine-gun-like noises usually come from small muscle spasms in the middle ear or around the Eustachian tube. Ordinary tinnitus can rise and fall. The simple test is to feel your pulse while you listen: true pulsatile tinnitus beats with it. Steady ringing is covered on the tinnitus page.
Why can I hear my heartbeat in my ear?
Usually because blood flow near the ear has become faster, more turbulent or easier to hear. The causes fall into a few groups:
Swipe sideways to compare →
| Group | Examples | Clues |
|---|---|---|
| Faster blood flow through the whole body | Strenuous exercise, pregnancy, severe anaemia, an overactive thyroid | Often in both ears |
| Turbulent flow in the arteries | Hardening of the arteries (atherosclerosis), high blood pressure | Found with a blood pressure check and a circulation examination |
| Raised pressure around the brain | Idiopathic intracranial hypertension (IIH) | Headaches and changes in vision; most common in young or middle-aged women who are overweight |
| Blood vessel abnormalities near the ear | Arteriovenous malformations, abnormalities of the large veins beside the brain, an artery in the middle ear that stayed open after birth | Found on scans |
| Growths with their own blood supply | Head and neck tumours that make abnormal blood vessels, most of them benign | A lump in the neck, or a growth seen on the eardrum |
| The ear hearing the body more | Conductive hearing loss, such as a perforated eardrum or glue ear | Muffled hearing in the same ear |
| Other | Head injuries, Paget’s disease of the bone | A recent head injury |
Pulsatile tinnitus in both ears is often linked to the heart and circulation, while pulsatile tinnitus in one ear needs an examination of the ear and neck. Both need assessing.
Is pulsatile tinnitus dangerous?
The sound itself is not dangerous, and many causes, such as anaemia, an overactive thyroid or high blood pressure, are common and treatable. But pulsatile tinnitus is often a symptom of something else, and it can be the first sign of a condition affecting blood flow, which is why doctors treat it as a red flag that always needs assessing, rather than something to live with.
Get help straight away if it started suddenly or comes with problems with balance or vision, and have pulsatile tinnitus in one ear examined promptly. Left untreated, pulsatile tinnitus can also lead to low mood and anxiety, which deserve treatment too.
Can pulsatile tinnitus go away?
Often, yes, when the cause is found and treated. Treating anaemia, an overactive thyroid or narrowed arteries can reduce the sound or stop it. Pulsatile tinnitus from a temporary rise in blood flow, such as after hard exercise, settles when the body does.
How is pulsatile tinnitus investigated?
Finding the cause starts with a careful history and examination, then simple tests, then scans when they are needed:
Swipe sideways to compare →
| Test | What it looks for | Where |
|---|---|---|
| History and pulse check | Whether the sound keeps time with the pulse, and the clues to the cause | By video or in person |
| Blood pressure, heart and circulation check | High blood pressure and heart causes, especially when both ears are affected | In person or with a home monitor |
| Blood tests | Anaemia (full blood count) and an overactive thyroid | In person |
| Ear examination | A hole in the eardrum, fluid, or a red mass behind the eardrum | In person, with an otoscope |
| Neck examination and stethoscope | A lump in the neck, and a sound the doctor can hear over the ear or neck | In person |
| Hearing test | Hearing loss in the affected ear | In person |
| Scans | MRI, CT, angiography or a Doppler ultrasound of the neck vessels, to look at the blood vessels near the ear | In person, usually arranged by a specialist |
| Eye examination | Signs of raised pressure around the brain, if that is suspected | In person, with an eye specialist or neurologist |
What might the doctor recommend for pulsatile tinnitus?
What happens next depends on how it started, whether one ear or both are affected, and what comes with it. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| With a sudden severe headache, stroke signs, loss of vision or a head injury | Emergency care | No | Call 112 now |
| Started suddenly, or with headaches and blurred vision | Urgent assessment | Only to assess | Urgently: get medical advice the same day |
| In both ears, otherwise well | Blood pressure, blood tests for anaemia and thyroid, and a heart and circulation check | Yes, to assess | For the checks and tests |
| In one ear | An ear and neck examination, a hearing test, and a specialist referral | Yes, to assess | For the examination, the hearing test and any scans |
| With a lump in the neck, or hearing loss in the same ear | Prompt specialist referral | Only to assess | For examination and scans |
| Clicking that does not keep time with the pulse | Assessment and explanation | Yes | If it changes, or comes with hearing loss |
Hearing your heartbeat in your ear? A doctor can tell you in one consultation which tests you need and how soon.
See available times →Treatment options for pulsatile tinnitus
Treatment is treatment of the cause. When the cause is found and treated, the sound often fades or stops.
What you can do yourself
- Check whether the sound keeps time with your pulse, and note when it started, which ear, and what makes it louder or quieter.
- Take a blood pressure reading if you have a home monitor, and bring the results to the doctor.
- Use low background sound, such as a fan, soft music or a sound machine, especially at bedtime or in quiet rooms.
- Manage stress, which can make the sound feel worse, with relaxation, exercise and good sleep habits.
- Do not wait for it to go away by itself before getting it checked.
Prescription treatment
A prescription is never issued without a consultation. There is no medicine for the sound itself. Once tests have found the cause, the doctor may prescribe treatment for it, such as for high blood pressure, anaemia or an overactive thyroid, and other causes are treated by a specialist. Talking therapies such as cognitive behavioural therapy can help with the distress. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Waiting for it to settle without an assessment. Trying to treat the sound itself before the cause is known.
Special situations
Pregnancy
Blood flow rises in pregnancy, which can make you aware of your pulse in your ears. It still needs checking, together with your blood pressure and blood count, especially with headaches or changes in vision.
Headaches with blurred vision
Pulsatile tinnitus with headaches and changes in vision can be a sign of raised pressure around the brain, which needs an eye examination and specialist assessment promptly. A sudden, severe headache is an emergency: call 112.
Anxiety and sleep
A sound that beats with your heart is hard to ignore, especially at night. Background sound and stress management help while the cause is investigated, and the anxiety and insomnia pages cover what a doctor can do.
Pulsatile tinnitus while travelling in Europe
If it starts on holiday with any warning sign, call 112 wherever you are. Otherwise, see a doctor promptly, and keep any test results to share with your own doctor at home.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When pulsatile tinnitus is assessed online, and when you need in-person care
Assessed online: confirming that the sound is pulsatile, checking the warning signs, working out the likely causes, deciding which tests you need and how soon, and support while you wait for them.
In-person care: blood pressure and blood tests, the ear, neck and heart examination, hearing tests, scans and specialist treatment, and any pulsatile tinnitus with a warning sign.
When to get in-person care
Call 112 or go to an emergency department now for:
- pulsatile tinnitus with a sudden, severe headache
- facial drooping, weakness, numbness, slurred speech or confusion
- double vision or loss of vision
- pulsatile tinnitus after a head injury
Get medical advice the same day for:
- a rhythmic whooshing that started suddenly
- pulsatile tinnitus with headaches and blurred or dimmed vision
- pulsatile tinnitus with sudden hearing loss
- pulsatile tinnitus with new problems with balance
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the sound: say whether it keeps time with your pulse, which ear, when it started and what comes with it, and share any blood pressure readings.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Pulsatile tinnitus can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Tinnitus can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about pulsatile tinnitus
What is pulsatile tinnitus?
A rhythmic whooshing, swooshing or thumping in the head or ears that keeps time with your heartbeat. It is a rare form of tinnitus, and it is often the sound of blood flowing through vessels near the ear.
What does pulsatile tinnitus sound like?
Pulsatile tinnitus sounds like a whooshing, swooshing or thumping in one ear or both, in exact time with your heartbeat: it speeds up when you exercise or feel anxious and slows when you rest. You can check by feeling your pulse at the wrist while you listen. It is often louder at night or in a quiet room, and some people can change or stop it by pressing on the neck or turning the head, which is a useful detail to tell the doctor.
Why can I hear my heartbeat in my ear?
Pulsatile tinnitus usually happens because blood flow near the ear is faster, more turbulent or easier to hear. Causes include exercise, pregnancy, anaemia, an overactive thyroid, high blood pressure, hardening of the arteries, blood vessel abnormalities, and ear problems that muffle outside sound.
Is pulsatile tinnitus dangerous?
The sound of pulsatile tinnitus itself is not, and many causes are common and treatable. But it can be the first sign of a condition affecting blood flow, so it always needs assessing by a doctor, urgently if it started suddenly or comes with headaches, vision or balance problems.
Why is pulsatile tinnitus a red flag?
Because, unlike ordinary tinnitus, it often has a physical cause, from anaemia or thyroid problems to blood vessel abnormalities or raised pressure around the brain. Doctors look for the cause rather than reassure.
How common is pulsatile tinnitus?
Pulsatile tinnitus is a rare form of tinnitus, making up a small minority of cases seen in tinnitus clinics. Tinnitus of any kind is common: surveys estimate that 10 to 25% of adults have it, most often a steady ringing, buzzing or hissing rather than a sound in time with the pulse.
How do I stop the pulsing in my ear?
By finding and treating the cause of the pulsatile tinnitus, which often reduces or stops it. Meanwhile, low background sound such as a fan or soft music, especially at night, and stress management make it easier to live with.
What can I do at home about pulsatile tinnitus?
Get it assessed first, because pulsatile tinnitus needs a cause found. Meanwhile, mask it with low background sound such as a fan, a radio or soft music, especially at night; cut down on caffeine, alcohol and salt, which can raise blood pressure; keep a note of when it is loudest and whether head position changes it; and avoid lying on the affected ear if that makes it louder. Treating anxiety and poor sleep makes any tinnitus easier to live with.
Can pulsatile tinnitus be prevented?
Not always, but the common causes can be: keep blood pressure under control, treat anaemia and thyroid problems, keep to a healthy weight, since raised pressure inside the head linked to weight gain is a recognised cause in younger women, and do not smoke, which hardens the arteries. Protect your ears from loud noise, because hearing loss makes the body's own sounds easier to hear. Pulsatile tinnitus that appears suddenly still needs a doctor, whatever you have done to prevent it.
What is mistaken for pulsatile tinnitus?
Clicking or machine-gun-like noises from small muscle spasms in the middle ear, and ordinary tinnitus that rises and falls. Feel your pulse while you listen: true pulsatile tinnitus keeps time with it.
Can pulsatile tinnitus go away?
Often, yes, when the cause is treated: pulsatile tinnitus from anaemia, an overactive thyroid or high blood pressure usually fades once those are corrected, and a blood vessel problem can often be repaired. Pulsatile tinnitus from a temporary rise in blood flow, such as after hard exercise or in pregnancy, settles by itself.
What tests are done for pulsatile tinnitus?
For pulsatile tinnitus, a history and examination of the ears, neck and heart, blood pressure, blood tests for anaemia and thyroid problems, a hearing test, and often a scan such as MRI, CT, angiography or a Doppler ultrasound of the neck vessels.
When is pulsatile tinnitus an emergency?
Call 112 if pulsatile tinnitus comes with a sudden severe headache, facial drooping, weakness, slurred speech, confusion, double vision or loss of vision, or after a head injury.
Can an online doctor help with pulsatile tinnitus?
Yes, with the assessment. A doctor can confirm by video that the sound is pulsatile, check the warning signs, work out the likely causes and arrange the right tests. Finding and treating the cause happens in person.
- Tinnitus, NHS, National Health Service (UK), reviewed 12 January 2024.
- Pulsatile tinnitus, Cleveland Clinic (US), reviewed 9 September 2025.
- Tinnitus: pulsatile, NHS Greater Glasgow and Clyde, Right Decisions ENT referral guidance, reviewed 7 May 2025.
- Tinnitus, NIDCD, US National Institute on Deafness and Other Communication Disorders, updated 1 May 2023.
- Pulsatile tinnitus, Tinnitus UK (British Tinnitus Association), written by a consultant otolaryngologist, updated March 2022.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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