Have you ever noticed a soft thumping or whooshing sound in your ear when everything around you is quiet, like when you're lying in bed at night? It feels like your heartbeat has moved into your ear, playing on repeat. You pause, try to figure out where it’s coming from, and realise, it’s coming from inside you.
Many people have found themselves lying still, trying to determine whether it was the fan or just their imagination. The spoiler is it wasn’t either. We spoke to Dr Lalit Mohan Parashar, Head of Department - ENT, Minimal Access Smart Surgery Hospital (MASSH), Delhi, who explained this whooshing in your ears, known as pulsatile tinnitus.
What Is Pulsatile Tinnitus?
“Pulsatile Tinnitus (PT) is a specific type of tinnitus in which you hear a rhythmic sound that matches your heartbeat, often described as a gentle whoosh or soft drumbeat that's in sync with your pulse. Unlike the more common ringing or buzzing tinnitus (non‑pulsatile), PT feels like your circulatory system performing a solo near your ears,” said Dr Parashar.
Medically, PT can be subjective (only heard by you) or objective (detectable by a clinician), which makes it unusual, since most tinnitus is subjective only, according to a 2020 study.
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Why Does This Happen?
This isn't your typical high-pitched ringing tinnitus. That’s a different type. Pulsatile tinnitus is more like a soft drumbeat that syncs with your heartbeat. It’s your body playing background music, sometimes harmless, sometimes hinting at something deeper.
“In many cases, it’s tied to how blood flows near your ears. If that flow gets turbulent due to high blood pressure, a narrow artery, or even something mundane like anaemia, your ear picks up the beat. Sometimes it’s just your auditory nerve doing a bit too much. Other times, it’s an overzealous blood vessel making itself known,” added Dr Parashar.
In rare cases, pulsatile tinnitus may also be caused by thinning of the bones in the ear, which leads to transmitted sounds from the surrounding organs’ blood circulation.
Another possibility includes growth or a tumour in the nerve that runs from the ear to the brain, which may interfere with sound perception. And occasionally, it’s just earwax. This little buildup can turn your ear into a mini echo chamber.
Dr Parashar said, “While not always serious, pulsatile tinnitus can sometimes signal an underlying vascular or neurological issue. Persistent or one-sided symptoms are worth investigating with imaging tests and a full evaluation.”
When Should You Start Worrying?
If it comes and goes, especially after exercise or stress, it may be your circulatory system just doing its thing. But if it sticks around, especially if it’s only in one ear, or if it comes with other symptoms like headaches or dizziness, then it deserves more than a shrug.
Watch out if the pain is:
- One-sided
- Persists for two weeks
- Gradually increasing
A good rule of thumb: if the noise has become a regular character in your daily soundtrack, it’s time to call in a specialist.
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What Can Be Done?
- Start with an ENT visit.
- You may be asked to undergo an MRI or a CT angiogram to rule out any serious conditions.
- Additional hearing tests, such as pure tone audiometry and other audiological evaluations may also be recommended to assess hearing function.
- Sometimes, all you need is a lifestyle tune-up: better sleep, less caffeine, lower stress.
- Treatment, besides the general measures listed, involves addressing the underlying cause if one is found, whether vascular, neurological, or structural. Sometimes, medical treatment is necessary to address an underlying issue.
Bottomline
Dr Parashar concluded, “Think of pulsatile tinnitus like a whisper from your body. It’s subtle, repetitive, and easy to ignore. But whispers often mean something, and sometimes listening is the smartest thing you can do.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]