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32 years
I've been experiencing pounding in my right ear that comes and goes during the day. Should I get this checked? Can it be hypertension?
Mar 30, 2015

Dr. Zakia Dimassi Pediatrics

It happens sometimes that
you hear the sound, or even feel the pounding, of your heartbeat in your ear
when lying down to sleep at night. Placing the head on your pillow can make you
aware of the sound of your heartbeat in your ear. In some cases you may hear
your heartbeat only in one ear.



The medical term for this
phenomenon is pulsatile tinnitus. The underlying causes of this condition can
vary. In the majority of cases, pulsatile tinnitus is a self-limited condition;
if it becomes especially annoying, only then do you need to be seen by a doctor,
who should listen (with the stethoscope) to the blood flow in the arteries of
the neck and examine the ears, checking for a sound that indicates that there
is an obstruction. If this sound is present, he/she should request tests to
check for carotid arteries, narrowing or malformations.



One of the factors that can
increase tinnitus symptoms is stress, so stress avoidance and management are
important in reducing symptoms. Alcohol is known to dilate the blood vessels,
thereby enhancing blood flow, particularly to the inner ear. It is therefore
important to decrease alcohol consumption.





Causes of Pulsatile Tinnitus

1. Generalized Blood Flow



Fast blood flood flow,
associated with physiological events (such as during exercise) or with disease
conditions (e.g., anemia or an overactive thyroid gland), will produce more
noise than when the blood is flowing slowly through the blood vessels.



2. Localized Blood Flow



If a blood vessel or
group of blood vessel is blocked, there will be compensatory increase in blood
flow in the neighboring blood vessels. This could occur if one of the arteries
in the middle ear is blocked.



3. Turbulent Blood Flow



Blood flow within a
vessel may experience some turbulence, often as a result of hardening of the
arterial walls (atherosclerosis) in people with risk factors (obesity, smoking,
elevated cholesterol etc.).



4. Altered Awareness



Altered awareness can be
caused by an increase in the sensitivity of the auditory pathways or hearing
loss caused by damage to the ear.



 



With a number of possible
underlying causes, it remains best to be examined by an ear-nose-throat
specialist to better define the problem and manage it properly.



 

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