What does pulsatile tinnitus sound like?

Pulsatile tinnitus, also known pulse synchronous tinnitus, is a rhythmic thumping, whooshing or pulsing in the ear. It’s a rare form of tinnitus that tends to be synced to your heartbeat, and can seem as if you’re hearing your heartbeat in your ears. Pulsatile tinnitus can occur in one or both ears, and it can change in pace or tone in relation to changes in your heart rate. 

What are the symptoms of pulsatile tinnitus?

The most common symptom of this type of tinnitus is hearing a steady thumping sound in your ears that occurs without external noise. You might be more likely to hear your heartbeat in your ear when lying down at night, when there are fewer external noises to mask the ear thumping. 

Is pulsatile tinnitus dangerous?

Pulsatile tinnitus is not always dangerous, but it can be a sign of an underlying medical condition that requires attention. Unlike regular (non-pulsatile) tinnitus, which is usually caused by hearing loss or noise exposure, pulsatile tinnitus often stems from vascular or structural issues near the ear or brain.

Common causes include:

• High blood pressure
• Atherosclerosis (narrowing of the arteries)
• Arteriovenous malformations
• Venous sinus stenosis
• Benign intracranial hypertension
• Glomus tumors or other vascular growths

Some of these conditions can be serious if left untreated. For example, benign intracranial hypertension may lead to vision problems, and vascular malformations can carry a risk of bleeding. That’s why it’s important not to ignore pulsatile tinnitus—especially if it’s new, persistent, or occurs in only one ear.

In many cases, the cause is treatable or manageable once diagnosed. Imaging tests like MRI, MRA, or CT angiography are often recommended to identify the source. If you're experiencing pulsatile tinnitus, consult a doctor—preferably an ENT (ear, nose, and throat specialist) or a neurotologist. While the condition itself may not be harmful, proper evaluation ensures that any potentially serious causes are ruled out or addressed early.

Can I have pulsatile tinnitus in one ear only?

Yes, you can have pulsatile tinnitus in one ear only, and in fact, unilateral pulsatile tinnitus (affecting just one ear) is common and often more concerning than when it occurs in both ears.

Unilateral pulsatile tinnitus may be caused by:

• Vascular abnormalities near one ear, such as glomus tumors, arteriovenous malformations (AVMs), or venous sinus stenosis
• Abnormal blood flow in a specific artery or vein near one ear
• Benign intracranial hypertension, which may affect drainage pathways unevenly
• Structural issues, such as superior semicircular canal dehiscence or aberrant carotid artery pathways

Because pulsatile tinnitus in one ear can indicate an underlying anatomical or vascular issue, it's especially important to seek medical evaluation. Doctors may recommend imaging studies such as an MRI, MRA, or CT angiography to investigate the cause. In some cases, the sound may be linked to muscular causes (e.g. middle ear myoclonus), but a full medical workup is needed to rule out more serious conditions.

If you’re experiencing pulsatile tinnitus in just one ear—especially if it’s new, persistent, or accompanied by hearing changes—consult an ENT specialist or a neurotologist. Early diagnosis can help guide effective treatment or monitoring.

Does pulsatile tinnitus go away spontaneously?

Yes, pulsatile tinnitus can go away on its own in some cases, but this depends on the underlying cause.

If the tinnitus is caused by a temporary condition, such as:

• Elevated blood pressure
• Stress or anxiety
• Mild ear infections
• Reversible vascular changes
• Temporary ear canal blockage (e.g., earwax)

It may resolve without treatment once the underlying issue is addressed or resolves naturally.

However, when pulsatile tinnitus is linked to persistent or structural causes—such as vascular malformations, venous sinus stenosis, or benign intracranial hypertension—it is less likely to go away on its own and may require medical intervention.

Because pulsatile tinnitus is often related to blood flow or pressure changes near the ear or brain, it’s important not to assume it’s harmless. Unilateral (one-sided) pulsatile tinnitus, in particular, should be investigated thoroughly.

If you experience pulsatile tinnitus—especially if it's persistent, one-sided, or accompanied by other symptoms like headaches or vision changes—you should consult a healthcare provider. A proper diagnosis can determine whether the cause is benign, temporary, or potentially more serious, and can guide appropriate treatment or monitoring.

Is pulsatile tinnitus constant?

Pulsatile tinnitus can be either constant or intermittent, depending on its underlying cause.

In some people, it is continuous, heard as a steady rhythmic whooshing or pulsing sound in sync with the heartbeat. This is often the case when the tinnitus is related to persistent vascular conditions, such as:

• Atherosclerosis
• Arteriovenous malformations (AVMs)
• Venous sinus stenosis
• Benign intracranial hypertension

In other cases, pulsatile tinnitus may come and go, appearing during certain activities or body positions. For example:

• It may be more noticeable at night, in quiet environments.
• It can appear or worsen with increased blood pressure, stress, or physical exertion.
• Head or neck movement may trigger or change the intensity if a structural issue is involved.

Intermittent pulsatile tinnitus can also be linked to transient causes, such as:

• Mild ear infections
• Earwax impaction
• Temporary changes in blood flow or pressure

Regardless of whether it's constant or occasional, pulsatile tinnitus should always be evaluated by a healthcare professional, especially if it's new, persistent, or one-sided. Diagnostic imaging (like MRI or CT angiography) may be needed to identify or rule out serious causes.

How to stop pulsatile tinnitus and ears ringing?

Stopping pulsatile tinnitus and ear ringing depends on identifying and treating the underlying cause. Pulsatile tinnitus—a rhythmic sound that matches your heartbeat—is often linked to vascular issues such as high blood pressure, turbulent blood flow, or venous sinus abnormalities. In contrast, constant ear ringing (non-pulsatile tinnitus) is usually related to hearing loss, noise exposure, or inner ear damage.

If you're experiencing pulsatile tinnitus, start by consulting an ENT specialist or audiologist. They may recommend imaging tests like an MRI or CT angiography to check for blood vessel irregularities or tumors. Treating conditions like hypertension, anemia, or vascular malformations can often reduce or eliminate the pulsating sound.

For non-pulsatile ringing, management focuses on reducing the perception of the noise. This may include sound therapy, cognitive behavioral therapy (CBT), hearing aids (if hearing loss is present), or tinnitus retraining therapy.

Stress and anxiety can worsen both types of tinnitus, so relaxation techniques, sleep support, and mindfulness practices may help reduce symptom intensity. Lifestyle changes such as avoiding loud noise, caffeine, and nicotine can also help. In some cases, professional treatment combined with self-care strategies can significantly reduce or resolve tinnitus symptoms over time. Always seek medical advice to determine the safest and most effective treatment.

Can pulsatile tinnitus be prevented?

While health conditions can’t always be prevented, there are a few steps you can take to support and maintain your physical and hearing health. Given the interrelation with the heart health and blood flow, maintaining healthy cholesterol and blood pressure levels may prevent pulsatile tinnitus. A healthy diet and regular exercise are important habits that can improve and support your health now and in the future.