Many doctors hear their patients complain that they can hear heartbeat in the ear. It is possible for this to happen, and it usually involves one ear. The throbbing sensation may start gradually or just occur suddenly, usually while you are lying down. Although it seems harmless, it may disturb you while trying to sleep or while you are at work.

What Could It Be If I Can Hear My Heartbeat in My Ear?

If you can hear heartbeat in your ear often, you must be experiencing what is called pulsatile tinnitus, or a rhythmic pulsation that is in coordination with your normal heartbeat. This condition is also called avascular tinnitus, which may be related to blood flow disturbances. It is estimated that about three percent of tinnitus patients have this kind of sensation.

Although most cases of tinnitus involves a ringing or buzzing sensation in the ear, some people experience pulsatile tinnitus, which usually comes from blood vessels in the head or neck when blood flow is disturbed. It may result from either an increase in blood flow or due to the narrowing of a blood vessel. Both of these conditions result in turbulence in blood flow, which can make you complain, "I can hear my heartbeat in my ear." It is therefore totally different from a continuous type of tinnitus that is associated with damage to the auditory nerve or the cochlea in the inner ear.

Is It Dangerous? What Should I Do?

In most cases, pulsatile tinnitus is not a thing you should worry about. It usually goes away on its own. However, if it begins to disrupt your activities and bother you, it is best for you to talk to your doctor.

Your doctor will conduct an ear examination and listen to your blood flow in the arteries of the neck. An unusual sound may be heard as blood rushes past some obstruction in the artery. If present, your doctor may request a test to investigate for a narrowing of an artery or a possible malformation in the carotid artery. Depending on the results, surgery might be recommended to correct the underlying problem. Others may need to undergo a hearing test or some other additional tests.

What Causes Pulsatile Tinnitus and What Can Be Done?

"I can hear my heartbeat in my ear, why?" The common causes of pulsatile tinnitus include:

1. Benign Intracranial Hypertension

Benign intracranial hypertension is due to an increased pressure in the cerebrospinal fluid in the brain. Most patients with this condition are young overweight females. Other symptoms include dizziness, hearing loss, headaches, ear fullness, and visual disturbances.

Treatment includes the use of diuretic (water pills) and weight loss, which usually results in dramatic improvement of symptoms.

2. Glomus Tumor

Glomus tumor is a non-malignant vascular tumor in the ear or at the base of the skull, below the ear. It consists of intertwined blood vessels that cause a throbbing sensation. Another common symptom is hearing loss.

Treatment often involves surgical removal of the tumor in young patients. Older patients may not need any treatment since these tumors grow very slowly.

3. Atherosclerotic Carotid Artery Disease

Atherosclerotic carotid artery disease results in the narrowing of the carotid artery. This blood vessel may be blocked due to the build-up of cholesterol in the inner wall of the artery, which results in turbulent blood flow and leads to pulsatile tinnitus. This is common in older patients who have a history of smoking, high blood pressure, high cholesterol, diabetes, and angina.

Treatment involves the use of medications to manage the underlying disorder.

4. Intracranial Vascular Lesions

Intracranial vascular lesions include aneurisms and arteriovenous malformations, consist of abnormal connections between arteries and veins. These abnormal blood vessels result in disturbances in blood flow from an artery directly to a vein. Aneurisms and arteriovenous malformations can be extremely dangerous because they can lead to bleeding in your brain.

Management includes surgery and embolization to close off the abnormal blood vessels.

5. Middle Ear Effusion

Middle ear effusion is due to the accumulation of fluid in the middle ear. The underlying cause may be an infection or inflammation in the middle ear or a Eustachian tube dysfunction. It may be accompanied by hearing loss, a feeling of fullness, and pain.

Treatment includes antibiotics, nasal sprays, decongestants, or in some cases, surgery.

6. Venous Hum

Venous hum may occur in pregnant or anemic individuals, or in patients who have thyroid problems. These conditions increase blood flow through the large jugular vein in the neck, which can be felt as a "humming" sensation.

Treatment of the underlying problem usually results in improvement of symptoms.

7. High Blood Pressure

High blood pressure is treated with antihypertensive medications, usually produces pulsatile tinnitus after intake of medication. However, tinnitus usually subsides on its own after four to six weeks. Other patients improve after a shift to other medications. In some patients, tinnitus is associated with high blood pressure, which resolves after intake of medication.

8. Twist Arteries

Twisted arteries in the head and neck can cause turbulence in blood flow, which can lead to pulsatile tinnitus. No treatment is necessary.