If we perceive the heartbeat unexpectedly, it is sometimes frightening. Sometimes there are serious illnesses behind it.
After exercise or other physical exertion, we sometimes feel our heart beating. As a rule, the noise disappears on its own after a short time. If not, a pulsating (pulse-synchronous) tinnitus could be behind it. The triggers can be varied and are not always harmless.
How does an audible pulse sound come about?
Pulse-synchronous tinnitus falls into the “objective tinnitus” category. It is a natural sound produced by a real source of sound very close to the inner ear: the rushing blood flow in the blood vessels. For most people, this form of tinnitus only occurs in one ear, but it can also affect both ears.
Because the ear pulse is an objective sensation, a doctor can easily diagnose it as part of a head exam. Imaging methods such as computed tomography (CT) or magnetic resonance imaging (MRI) can help to determine the cause of the pulse beats in the ear more precisely.
Temporary or permanent
In many cases, pulsatile tinnitus is not a cause for concern and disappears on its own within a short time. In young people, the ringing in the ears is often caused by listening to loud music with headphones or after going to a concert.
However, if the noise persists or keeps coming back, it may be a symptom of a deeper problem and should be checked out by a doctor. For example, long-term use of drugs such as antibiotics or diuretics (drugs that drain water) can lead to persistent pounding in the ears.
In rare cases, diseases of the head and neck vessels can also cause pulse-synchronous tinnitus. These include:
- Fistulas and hemorrhages in veins and arteries
- Vessel narrowing (stenoses) in atherosclerosis or a vascular wall tear
- Aneurysms (bulges in the wall of blood vessels, usually arteries) over it
- Tumors in or near the base of the skull
- abnormalities of veins
- Tissue structures that press on the neck vessels and constrict them, such as bone spurs
Stress as a trigger for tinnitus
Psychological factors such as stress, inner tension and mental strain are also associated with the rhythmic pounding in the ear.
“Stress can favor or intensify pulse-synchronous tinnitus,” explains cardiologist Professor Thomas Meinertz in the “Heart Clinic” of the German Heart Foundation. “It is well known that in stressful situations, the blood vessels constrict and the flow rate of the blood increases.”
Throbbing in the ear as an indication of high blood pressure
Meinertz points out that patients with high blood pressure are often affected by pulse-synchronous tinnitus. “Most of the time, the pulse in the ear also gets stronger – and is felt even more clearly in the ear when it’s quieter in the area.”
The cardiologist therefore recommends having your doctor check your blood pressure if you hear a pulse noise. Especially with advanced age, the vessels change and become stiffer. Therefore, increased blood pressure values could occur, even if this was not the case in more recent cases.
In any case, those affected should learn to control their stress, advises Meinertz. Relaxation exercises had a positive effect on both blood pressure and possible tinnitus. If there is no improvement, a thorough medical examination can be used to look for other possible causes that can explain a strong pulse in the ear.
How is pulse synchronous tinnitus treated?
The treatment options for pulse-synchronous tinnitus depend on its causes. If the ringing in the ear is caused by high blood pressure or a venous or arterial condition, it can be treated with appropriate medication and targeted lifestyle changes. These include regular exercise, quitting smoking and reducing stress.
In some cases, the causes can be treated with medication. In the case of vascular constrictions or anatomical abnormalities, they must be surgically corrected
Learn to block out the noise
If the doctor cannot find a specific trigger, treatment consists of learning how to best manage the condition. In concrete terms, this means that those affected must learn to largely ignore the tinnitus noises and thus minimize their effects on their everyday life.
Relaxation and mindfulness exercises can be just as helpful as sound therapy, cognitive behavioral therapy or targeted tinnitus retraining therapy. This special form of therapy focuses on processing the tinnitus in the central nervous system and thus on conscious perception.