Pulsatile Tinnitus: When to See a Cardiologist

Pulsatile tinnitus in the right ear?

I have been experiencing pulsatile tinnitus every night for the past four months.
I wake up in the early morning either feeling like I can't breathe due to a dream where a zipper won't close, or being awakened by the pulsatile tinnitus, which seems to be getting louder.
This morning, I measured my blood pressure: right arm 95/56 mmHg with a heart rate of 81, and left arm 93/54 mmHg with a heart rate of 80.
I would like to consult a doctor regarding my condition.
I have undergone EEG, MRI, and hearing tests, and there are no abnormalities found in my throat or neck.
As a physician with many years of experience, have you treated patients with pulsatile tinnitus in the right ear? Should I consider seeing a cardiologist for my right ear pulsatile tinnitus, also known as vascular pulsatile tinnitus? Thank you, doctor!

Lin Xin-Yi, 40~49 year old female. Ask Date: 2022/08/17

Dr. Li Han reply Cardiology

Hello, regarding your "pulsatile tinnitus in the right ear," it seems you have undergone several advanced diagnostic tests, including electroencephalography and magnetic resonance imaging, but no findings were noted.
Generally, vascular-related causes are rare but can pose risks, such as arteriovenous malformations or fistulas.
If such conditions were present, they should have been detected in the previous examinations.
It is advisable to discuss this further with your otolaryngologist.
The Changhua Hospital of the Ministry of Health and Welfare is concerned about your well-being.

Reply Date: 2022/08/17

More Info

Pulsatile tinnitus is a type of ear noise that is often described as a rhythmic sound that coincides with the heartbeat. This condition can be quite distressing, especially when it disrupts sleep or daily activities. Given your symptoms of pulsatile tinnitus for the past four months, along with episodes of waking up at night feeling breathless or disturbed by the sound, it is understandable that you are seeking further evaluation and guidance.

The first step in addressing pulsatile tinnitus is to understand its potential causes. This type of tinnitus can be associated with various conditions, including vascular abnormalities, increased blood flow in the vessels near the ear, or even issues related to the heart and circulatory system. In some cases, it may be linked to conditions such as hypertension, atherosclerosis, or arteriovenous malformations. Given your blood pressure readings of 95/56 and 93/54, which are on the lower side, it is essential to consider whether any underlying cardiovascular issues could be contributing to your symptoms.

Since you have already undergone several tests, including EEG, MRI, and hearing assessments, and found no significant abnormalities in the throat or neck, it may be prudent to consult a cardiologist. A cardiologist can evaluate your heart health and circulation, which may provide insights into whether there is a vascular component to your pulsatile tinnitus. They can perform tests such as an echocardiogram or Doppler ultrasound to assess blood flow and check for any abnormalities in the heart or major blood vessels.

Additionally, it is important to consider other factors that could be contributing to your symptoms. Stress, anxiety, and fatigue can exacerbate the perception of tinnitus. If you are experiencing significant distress or anxiety due to your symptoms, discussing these aspects with a healthcare provider may also be beneficial. They can provide strategies for managing stress and anxiety, which may help alleviate the intensity of the tinnitus.

In summary, while pulsatile tinnitus can sometimes resolve on its own, persistent symptoms warrant further investigation. Given your history and current symptoms, seeing a cardiologist is a reasonable next step. They can help determine if there are any cardiovascular issues that need to be addressed. Additionally, if you have not yet consulted an ear, nose, and throat (ENT) specialist, it may also be beneficial to do so, as they can provide further insights into potential ear-related causes of your symptoms.

In conclusion, while pulsatile tinnitus can be a benign condition, it is essential to rule out any underlying vascular or cardiovascular issues, especially given your symptoms and blood pressure readings. A multidisciplinary approach involving both cardiology and ENT specialists may provide the most comprehensive evaluation and management plan for your condition.

Similar Q&A

Understanding Pulsatile Tinnitus: Causes and Management Strategies

Hello, Dr. Jiang. 1. I have been experiencing tinnitus (various sounds, primarily a distant roaring noise, usually in the left ear, with a very rare occurrence of a sudden long beep in the right ear that gradually diminishes to normal, while the left ear continues with the roar...

Dr. Jiang Junyi reply Neurology
Hello, based on your description, it seems to be a vascular-related issue, but the instruments can only detect large blood vessels. You have a history of myocardial infarction and some neurological symptoms. It may be necessary to consider obstructive sleep apnea: if you have thi...

Understanding Pulsatile Tinnitus: When to Seek Medical Attention

Hearing a pulsing sound similar to a bell while sleeping can sometimes be considered normal. However, if you are experiencing a "thumping" sound in your left ear while walking, it may indicate a potential issue related to the auditory or neurological systems. This could...

Dr. Jiang Junyi reply Neurology
Hello: The tinnitus you mentioned may be a symptom of unstable eardrum. If it is pulsatile tinnitus synchronized with your heartbeat, the concerning conditions could be vascular abnormalities such as arteriovenous malformations or severe vascular stenosis. In such cases, the freq...

Which Specialist Should I See for Anxiety and Pulsating Symptoms?

Hello, doctor. I previously visited a psychiatrist who diagnosed me with mild anxiety disorder. During the National Day holiday, I suddenly experienced a headache and consulted an otolaryngologist, who prescribed painkillers for me. The headache lasted for about two days, but it ...

Dr. Ye Qianyu reply Family Medicine
Hello! Based on your description, the pulsating sound you hear in your ear is a symptom of tinnitus. It is recommended that you follow up with an otolaryngologist for further examination.

Understanding Pulsatile Tinnitus: Symptoms and Next Steps for Relief

I experience daily headaches, and at night, my feet feel numb up to my calves. My elbows and hands also go numb twice. At night, I feel something strange with my heart. When I measured my blood pressure, it was 96/52 with a heart rate of 71 on the right arm, 90/53 with a heart ra...

Dr. Jiang Junyi reply Neurology
Dear Miss Lin, You mentioned that you are experiencing "numbness in the soles of your feet extending to your calves, and numbness from your elbows to your palms." It is advisable to consult a neurologist to rule out peripheral nerve issues. Regarding your symptoms of...