Persistent Visible Pulsations in Neck Vessels: Possible Causes and Solutions

The blood vessel is continuously pulsating?

There is noticeable pulsation of the blood vessels on both sides of the neck (sometimes, other parts of the body also feel the vessels pulsating), and the skin visibly undulates.
This has been ongoing for more than two years, and the symptoms are becoming increasingly severe.
I have consulted with several cardiologists and neurologists, but no cause has been identified.
I have undergone an electrocardiogram, 24-hour Holter monitoring, exercise stress testing, echocardiography, and carotid ultrasound, all of which returned normal results.
What could be the possible causes?

peter, 30~39 year old female. Ask Date: 2023/10/25

Dr. Wu Xueming reply Cardiology

If all the above tests are normal, there is no need to worry.
This is mainly because the arteries are relatively superficial, which makes the pulsation more pronounced.

Reply Date: 2023/10/25

More Info

Persistent visible pulsations in the neck vessels can be concerning and may indicate various underlying conditions. Given your symptoms have persisted for over two years and have become more pronounced, it is essential to consider several potential causes and avenues for further investigation.

Possible Causes
1. Increased Blood Flow: Conditions that increase blood flow to the neck area, such as hyperthyroidism or anemia, can lead to visible pulsations. Hyperthyroidism increases metabolism and can cause the heart to pump more vigorously, resulting in pronounced pulsations.

2. Vascular Abnormalities: Abnormalities in the blood vessels, such as arteriovenous malformations (AVMs) or aneurysms, can lead to visible pulsations. These conditions may not always be detected through standard imaging, so specialized imaging techniques might be necessary.

3. Increased Intracranial Pressure: Conditions that increase pressure within the skull can lead to changes in blood flow dynamics, potentially causing pulsations in the neck vessels. This could be related to conditions such as idiopathic intracranial hypertension.

4. Muscle Tension or Spasms: Sometimes, muscle tension in the neck can create a sensation of pulsation. This is often related to stress or poor posture and may be exacerbated by anxiety.

5. Nerve Irritation: Irritation of the vagus nerve or other cervical nerves can lead to abnormal sensations or pulsations in the neck area. This could be due to cervical spine issues or other neurological conditions.

6. Cardiovascular Conditions: While you have undergone extensive cardiovascular testing, conditions like aortic regurgitation or other valvular heart diseases can sometimes present with unusual pulsations.

Recommended Next Steps
1. Further Imaging: If not already done, consider advanced imaging studies such as MRI or CT angiography to evaluate the vascular structures in more detail. This can help identify any vascular malformations or abnormalities that may not have been visible on standard ultrasounds.

2. Endocrine Evaluation: Since thyroid issues can lead to increased blood flow and pulsations, a thorough evaluation of thyroid function (including TSH, T3, and T4 levels) should be considered.

3. Neurological Assessment: Given that you have seen both cardiology and neurology, it may be beneficial to consult a neurovascular specialist who can assess for any potential vascular issues related to the brain or neck.

4. Lifestyle Modifications: Stress management techniques, such as yoga or meditation, may help alleviate muscle tension and improve overall vascular health. Regular cardiovascular exercise can also promote healthy circulation.

5. Follow-Up: Continuous follow-up with your healthcare providers is crucial. Keeping a symptom diary that tracks the frequency, intensity, and any associated symptoms can provide valuable information for your doctors.

Conclusion
Persistent visible pulsations in the neck vessels can arise from various causes, ranging from benign to more serious conditions. Given the duration and increasing severity of your symptoms, it is essential to pursue further evaluation and possibly seek a multidisciplinary approach involving specialists in cardiology, neurology, and vascular medicine. Early diagnosis and intervention can lead to better management of your symptoms and overall health.

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