Potential Causes of Pulsatile Tinnitus
As with other types of tinnitus (commonly known as ringing in your ears), pulsatile tinnitus can have many potential causes. It can sometimes be hard to distinguish among these potential causes to get a good diagnosis. However, here are some of the most common causes of pulsatile tinnitus to consider as you make an appointment with your primary care physician and/or an otolaryngologist in Columbia.
Conductive Hearing Loss
Conductive hearing loss is when something blocks your hearing from outside your body. As a result, the sounds from within your head sound louder. In addition to hearing your heartbeat in your ears, you likely also experience magnification of breathing and chewing.
There are many potential causes of conductive hearing loss, including earwax buildup, infection, a foreign object in the ear canal, a noncancerous tumor, or fusing of the bones of the middle ear.
Some of these causes are easily remedied, but others require surgery or other invasive procedures to treat. Talking to your Columbia otolaryngologist can help you distinguish the causes of hearing loss.
Sinus Wall Abnormalities
Sometimes blood that is supposed to flow near the ear gets diverted so that it flows in certain ways. This inefficient flow creates elevated pressure, which then translates into pulsatile tinnitus.
There is disagreement about how common this is. Some sources argue that it is a very common cause, accounting for up to 25% of all cases of pulsatile tinnitus (arguably the most common cause). Other sources argue that it’s a “very rare” cause of pulsatile tinnitus.
High Blood Pressure and Tinnitus
Sometimes, hearing your heartbeat in your ears might be related to having high blood pressure (hypertension). Not only is the pressure of blood moving through your nearby blood vessels higher, but the increased pressure might lead to a turbulent flow, which causes it to make more noise.
High blood pressure is very common, especially in people who are overweight or obese. It’s good to get your blood pressure tested as part of your routine physical.
In this condition, also called idiopathic intracranial hypertension, you experience elevated pressure not from your blood but from the cerebrospinal fluid that bathes your brain and spine.
In addition to pulsatile tinnitus, you will likely experience headaches, double vision, and pain behind the eyes.
Hardening of the Arteries and Tinnitus
One of the more common conditions associated with pulsatile tinnitus is atherosclerotic carotid artery disease (ACAD). This condition commonly referred to as hardening of the arteries, is when fats, bacteria, scar tissue, and other materials build up on the sides of the arteries. This buildup not only narrows the arteries, but it can break off, traveling down to narrower blood vessels and clogging them. In the case of the carotid artery, which is in the neck, the narrower blood vessels that get clogged may be in the brain, which results in a stroke.
When buildup starts in the arteries, it disrupts the flow of blood. The irregular blood flow causes turbulence, which causes vibrations that you hear. This is an important relationship because, in many patients, pulsatile tinnitus may be the first sign that the arteries are becoming clogged. If people get their pulsatile tinnitus checked out, it may allow them to get medication rather than surgery to treat ACAD and, even more important, may head off a stroke.
Burst Arteries and Tinnitus
Another potential cause of pulsatile tinnitus is a dissected carotid artery. In this condition, your carotid artery has been torn. Now it is allowing blood to come out into the space around your ear. As your heart beats, it increases the pressure in this area, resulting in the sound you hear.
Dissected arteries share one thing with ACAD: they increase your risk of stroke. In fact, a dissected carotid artery is the most common cause of strokes among people under the age of 50. They can be caused by neck trauma or neck overextension. And pulsatile tinnitus is very common in this condition, occurring in about 25% of people with a dissected carotid artery.