What Does It Mean When You Hear Your Heartbeat in Your Ear?

Have you ever heard your heart beating in your ear? This symptom may first be noticed when lying down to go to sleep at night. When you place your head on the pillow, you’re aware of the swishing sound of your own heart beating in your ear. For some people, the sound makes sleep impossible. Sometimes the heartbeat in the ear can be heard on one side only; less commonly, it can be heard in both ears. What causes the strange symptom and is it cause for concern?

Hearing the Heartbeat in the Ear: What It Means

The official medical term for the rhythmic swishing of the heart beating in the ear is pulsatile tinnitus. Like garden variety tinnitus, or ringing in the ears of the continuous type, the causes of pulsatile tinnitus are varied. Unlike continuous tinnitus that’s usually not due to a serious medical condition, pulsatile tinnitus can more often be a sign of a health problem and needs evaluation.

What Are Some Causes of Pulsatile Tinnitus?

Pulsatile tinnitus can sometimes be due to problems with blood flow through one of the arteries or blood vessels that lie near the ear. In some cases, it can be a symptom of an AV malformation which is an abnormal communication between blood vessels. This is a serious condition since the vessel can rupture leading to a stroke. Tumors, usually benign, located somewhere in the ear canal or in the skull can also cause pulsatile tinnitus. In some cases, hearing the heartbeat in the ear can be the first sign of atherosclerotic disease – a condition caused by plaque formation in the carotid arteries. This, too, can lead to stroke. In rare cases, pulsatile hypertension can be caused by hypertension. There a variety of other potentially serious causes of pulsatile tinnitus that are less common, but these examples illustrate the potentially serious nature of this symptom.  

Is Pulsatile Tinnitus Always Serious?

Not always. When fluid builds up in the middle ear for any reason such as infection or allergy, it can cause pulsatile tinnitus. Another condition called patulous eustachian tubes can amplify the sound of the heart beating in the ear. This condition occurs when the eustachian tubes, the tubes connecting the throat and the ears, which are normally closed remain open. A person with this condition not only hears their own heartbeat, but when they talk they may perceive the sounds to be muffled. This condition is often seen in people who lose a great deal of weight over a short period of time.

What to Do About It

Anyone who hears the sound of their own heartbeat in their ear needs evaluation by a doctor. In many cases, an MRI will be necessary to look for tumors or AV malformations. An ear exam can be done to look for fluid in the middle ear. In some cases, no cause for pulsatile tinnitus will be found and the symptom will disappear as quickly as it came.