Ear Issues Post-COVID: Tinnitus and Heartbeat Sounds Explained

Ear problems?

Three months ago, I was diagnosed with COVID-19.
I experienced loud tinnitus in my left ear, along with a pronounced heartbeat sound when I turned my head to the right.
I consulted an otolaryngologist at a major hospital, who listened to the blood flow in my ear and said everything sounded normal.
The doctor suggested that at certain angles, the blood vessels in my ear might be closer to the eardrum, and as long as I didn't hear the heartbeat constantly, it was not a concern.
I was advised to monitor the situation myself.
A cardiologist mentioned that this could be palpitations, possibly due to long COVID or autonomic nervous system dysregulation.
Now, three months later, the tinnitus has significantly decreased and is almost gone.
Additionally, I do not hear the heartbeat sound every time I turn to the right; it only occurs occasionally, and I need to be in certain positions, like sitting on the toilet or crossing my legs, to hear it (I was advised to test this myself).
Even when I do hear it, the sound is much quieter and intermittent, or I feel the blood vessels pulsing without sound, unlike the loud heartbeat I experienced during my COVID diagnosis, where it was continuous.
After my COVID diagnosis, I experienced several episodes of orthostatic hypotension, and changing positions felt exhausting.
I often felt my heart racing while doing tasks, but that has improved now.
Overall, my ear issues have improved by about 80%.
I would like to know if there is a possibility that it may not fully resolve, as I am concerned about long COVID not completely going away.
I found online that some people say this is related to long COVID, which may improve over time, or that I might need to take some supplements or consult traditional Chinese medicine.

The ear symptoms do not significantly affect my daily life since they have become very mild, but I tend to overthink things and hope for a complete resolution.
I am unsure what further efforts I can make or if I should adjust my mindset.
Thank you.

Cheng Cheng, 30~39 year old female. Ask Date: 2023/02/03

Dr. Peng Shiwei reply Neurology

Hello, based on your description, your symptoms have improved by 80%.
What you should do now is to maintain the current state and relax.
Engaging in more physical activity is also beneficial.
Wishing you a speedy recovery, and thank you for your question.

Reply Date: 2023/02/03

More Info

Understanding ear issues, particularly after a COVID-19 infection, can be complex and multifaceted. Your experience with tinnitus (the perception of noise, such as ringing or buzzing, in the ears) and the perception of heartbeat sounds in your ear (often referred to as pulsatile tinnitus) is not uncommon among individuals who have recovered from COVID-19.
Tinnitus can be triggered or exacerbated by various factors, including stress, anxiety, exposure to loud noises, and changes in blood flow. In your case, the onset of tinnitus and the heartbeat sounds following your COVID-19 diagnosis may be linked to several physiological changes that can occur during and after viral infections. The virus can affect the auditory system, leading to inflammation or changes in blood flow that may contribute to these symptoms.

The fact that your symptoms have improved significantly over the past three months is a positive sign. It suggests that your body is healing and adapting after the infection. The reduction in the intensity and frequency of the tinnitus and heartbeat sounds indicates that the underlying issues may be resolving. It is not uncommon for tinnitus to fluctuate in intensity, and many individuals experience periods of improvement followed by temporary exacerbations.

Regarding your concerns about whether the symptoms will completely resolve, it is important to understand that while many people do experience complete resolution of tinnitus, others may find that it persists at a lower intensity or becomes a chronic issue. The variability in recovery can depend on several factors, including the severity of the initial infection, individual health conditions, and the presence of any underlying auditory issues.

Your mention of experiencing postural hypotension (a drop in blood pressure upon standing) and feelings of fatigue could be related to autonomic nervous system dysregulation, which has been reported in some individuals post-COVID. This dysregulation can affect how your body responds to changes in position and can contribute to feelings of dizziness or lightheadedness, which may also influence your perception of tinnitus.

In terms of management, here are some strategies you might consider:
1. Cognitive Behavioral Therapy (CBT): This can help address anxiety and negative thought patterns associated with tinnitus. It can also assist in developing coping strategies to manage the perception of sound.

2. Sound Therapy: Using background noise or white noise machines can help mask the tinnitus and make it less noticeable.

3. Healthy Lifestyle Choices: Regular exercise, a balanced diet, and adequate hydration can support overall health and may help reduce tinnitus symptoms.

4. Stress Management Techniques: Practices such as mindfulness, meditation, or yoga can help reduce stress and anxiety, which may, in turn, alleviate tinnitus symptoms.

5. Follow-Up with Healthcare Providers: Regular check-ins with your ENT specialist or audiologist can help monitor your condition and provide additional strategies tailored to your needs.

6. Nutritional Support: While there is no specific "cure" for tinnitus, some individuals find that certain vitamins and supplements, such as magnesium or B vitamins, may help. However, it's essential to consult with a healthcare provider before starting any new supplements.

7. Alternative Therapies: Some people explore acupuncture or herbal remedies, but the efficacy of these treatments can vary, and it's crucial to approach them with caution.

Lastly, adjusting your mindset can be beneficial. Focusing on the improvements you've made and recognizing that fluctuations are normal can help reduce anxiety about the condition. It's understandable to have concerns about long COVID and its potential long-term effects, but many individuals do see significant improvements over time.
In conclusion, while there is a possibility that some symptoms may persist, the likelihood of complete recovery remains high, especially given your recent improvements. Continue to monitor your symptoms, engage in self-care practices, and maintain open communication with your healthcare providers.

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