Can You Hear Your Own Heart Beat? Exploring Pulsatile Tinnitus I Vascular and Interventional Partners
Pulsatile Tinnitus is a complex condition that currently affects approximately five million Americans. Characterized by the perception of a pulsing, rhythmic noise that coincides with a patient’s heartbeat, this condition can be of great nuisance to those affected.
The main symptom of pulsatile tinnitus is hearing a steady sound in your ears that’s in sync with your heartbeat. Some people are even able to measure their pulse this way! However, you might also experience other, less useful symptoms as well, such as:
These symptoms can vary in frequency for different patients, with some experiencing intermittent symptoms and others having to deal with them consistently.
For a large majority of individuals, this condition is distracting and disruptive to their daily lives, especially at night when the rhythmic beating can be particularly bothersome (because there are fewer external noises to drown it out).
While common tinnitus is usually caused by damage to the auditory system, pulsatile tinnitus is instead caused by circulation issues or problems with the blood vessels and surrounding tissues in the head and neck. But when it comes to the specific causes of PT, there are several factors to consider.
Most commonly, narrowed veins or arteries in the neck can cause a change in blood flow to the head, creating turbulent blood flow that the ears can detect.
A rare but life-threatening cause of pulsatile tinnitus is a dural Arteriovenous fistula. This is an abnormal connection of a high-pressure artery to a vein. Veins are not able to accommodate such high pressure and begin to dilate and may eventually rupture, resulting in a life-threatening bleed into the brain.
Other possibilities are high blood pressure, for example, can increase the force of the blood pushing against the walls of the arteries and lead to a more forceful blood flow that the ears can detect.
Lastly, a potential cause of pulsatile tinnitus is atherosclerosis, a blockage in the arteries caused by plaque buildup, which can create turbulent blood flow. This turbulence can, in turn, be responsible for the rhythmic noise in the ears.
Pulsatile tinnitus is typically diagnosed through a physical exam, medical history review, and the use of a stethoscope to listen for the presence of a pulsatile noise in sync with the heartbeat. Many times, patients may be told that their pulsatile tinnitus is subjective.
Additional tests, such as audiological evaluations and imaging tests, may also be conducted to determine the cause. Imaging tests can reveal any structural or vascular abnormalities that may be causing a patient’s symptoms.
The treatment of PT depends on the underlying cause. Lowering blood pressure with medication and lifestyle changes may sometimes alleviate symptoms. However, if the problem is related to the veins or arteries, minimally invasive procedures may instead be used to improve blood flow and alleviate symptoms.
At Vascular and Interventional Partners (VIP), we use minimally invasive, image-guided techniques to treat pulsatile tinnitus when other cures have failed. The biggest difference in our approach is that we address the condition's underlying cause, which is often a vascular issue.
At VIP, we’ve developed additional vascular techniques to identify the causative agents of the turbulent blood flow. Once the cause has been identified, we can then discuss the treatments with our patients.
Treatment for this condition involves inserting a small catheter into a blood vessel through a small incision in the skin and guiding it to the affected area using real-time imaging with fluoroscopy and intravascular ultrasound. Once the catheter is in place, our clinicians can use various techniques to alleviate the symptoms of this complex condition.
One technique we use is called Coil Embolization, which involves filling the abnormal blood vessel with small metal coils to prevent blood from flowing through it and creating a pulsatile sound. Another option is using a stent to open the blood vessel if the underlying issue is a narrowing or blockage of a blood vessel.
Each of these therapies for pulsatile tinnitus is performed on an outpatient basis. Patients typically experience very little discomfort with this approach and should be able to resume their normal activities within a day or two.
To learn more about Pulsatile Tinnitus and the treatment options available at VIP, check out our Procedures page!
