New to Pulsatile Tinnitus...

[ScoutLee]

Hello.

I'll try and keep this succinct!

I'm 29, and I've only been having pulsatile tinnitus for about 4 months or so, so fairly new to me.

It started when I had some severe heart palpitations (due to a heart condition I have which is monitored by a cardiologist). A night after a particularly bad episode, I started getting the wooshing, but just on my left side, so unilateral. Both ears get the annoying, high pitched ringing, but just my left gets the wooshing. At first, it just irritated me, but only seemed to happen late in the day / at night, or perhaps it was just quieter in the day or harder to hear. I had it for a series of nights and then it went away initially, but has since come back several times.

In the past few weeks, I have had some fairly severe episodes of it, and now it comes and goes in the day, too. One night about a week ago, it nearly made me throw up. The nausea it caused was so unpleasant, and it also gave me noticeable pain on the left side of my neck, especially near my ear. I took myself to my GP the next day, and he listened to my arteries with a stethoscope. He said he couldn't hear a bruit, as I wasn't experiencing the tinnitus at the time of the appointment, but he wanted me to have a doppler of my carotid arteries. I am doing that tomorrow afternoon.

I suppose I just wanted to document the experience here, hopefully finding a cause as soon as possible, but I have to admit: I am a little nervous about all this. I realise some causes can be quite serious in nature.

I'm fairly certain the cause is vascular in nature, as it so obviously coincided with my heart issues. My BP has been all over the place, too, and I realise that can certainly be a cause, but when I did a 24 hour BP moniter, they said — despite some BP spikes due to stress — that my base BP was in the healthy range.

My collective symptoms are (other than the the wooshing itself): dizziness, nausea, hearing issues, pain in the ear / neck which often runs down, jaw pain and areas of intermittent facial numbness. I've also had several instances where the wooshing wasn't present, but a loud thumping was.

I've heard that it can be a positive sign if the pulsatile tinnitus is intermittent, but I'm still concerned.

Just hoping for some advice / to see if anyone has had similarities, and what the cause for them was.

Thanks so much!

 

[Tanya2]

Hello, ScoutLee.

Welcome to the forum! Does your PT coincide with your pulse? If yes, this is PT. PT has many reasons. Heart conditions are the trigger point - especially when it is connected with high blood pressure, but you have written that this is ok in your case. The truth is that in my case it was vice-versa: when I started to have PT it made me feel heart palpitations - and now I think it was connected to my anxiety. PT has in fact many vascular reasons, but there are some reasons as thyroid disease or anemia, which are not vascular. PT also can be objective and subjective - not always it can be heard by doctor or another person. If doppler is clear, I would insist on MRI + MRA and MRV testing of your head. In my case it is possibly neurovascular conflict - a blood vessel in contact with my vii and viii nerve. But this diagnose is very uncertain - it could be something else. I would recommend to visit also ENT due to ear pain and dizziness and also for jaw pain maybe a dentist - to find out if it is TMJ - your jaw pain triggers eating, or chewing? Maybe the pain in your ear could be neurological - if there is not ear issues, also the feelings in your face and jaw. The procedure of testing should be done in order to exclude serious causes that might be connected to PT. Try not to worry so much - it makes PT worse. But try to find a cause, it is worth it. And if there is no cause revealed, have the tests done to exclude vascular issues. So try maybe this: ENT (don´t you have ear infection, maniere disease?), dentist (tmj?) - and if they could not help you, try neurologist in order to have MR. All the best to you! It will settle down, it only wants time and testing to be sure that it is nothing serious, or if it is - to be resolved.

 

[bichonlover]

I appreciate hearing from others to help me determine next steps. I experienced heartbeat noise in my ear about 3 weeks ago. Carotid ultrasound negative. No other symptoms but just started a new job and daughter moving out of state, so stress definitely could be a cause. I hear noise mostly at night, sometimes upon arising in the morning for a short time, so I'm okay with it as long as I am assured it's not caused by other serious conditions. I've started Crestor for high cholesterol, familial issue, no other medical conditions. Only get to speak to physician if I make an office appointment, otherwise it's a nurse who is not aware of conversation. After reading comments, my symptoms mimic PT but my mind still dwells on the fact that it's not a normal body function to hear noise, and could it be leading up to a stroke? Am I overreacting? I'm not an anxious person, just a concerned patient.

 

[bichonlover]

If an MRA test finds some type of vascular problem, is surgery always required? How is it fixed?

 

[stopthebeat]

If an MRA test finds some type of vascular problem, is surgery always required? How is it fixed?

I started having PT early Nov. I had a carotid Doppler that came back normal. Then I had an MRI/A. Yesterday I met with a neurologist and I was diagnosed as having a Condylar vein dural fistula.

In this particular condition the way they suggested fixing it is by using coils that are put in place by going through a vein in your thigh up to the jugular then over to the condylar vein.

The dr I saw said I could wait and it's possible it could resolve itself over time, but that it could also get worse and lead to stroke, seizures or bleeding in the brain. I'm trying to decide what to do next.

 

[ScoutLee]

Thanks so much for the replies.

@Tanya2 - Thanks so much for the advice. Indeed, my wooshing is in time with my heart. I'll write my update below. I'd love your advice on what I should do next.

@stopthebeat - I am so sorry to hear of your diagnosis. Are you going to be getting the surgery done soon?

@bichonlover - I am an anxious person too, so I really relate, but it is definitely best to be safe with this type of thing, as it can potentially be caused by a few serious conditions. I'd advise on getting the MRA, but try not to worry. Be calm and remember - forewarned is forearmed. If there are any problems, you'll be able to treat it! Stay positive.

Here's a quick update of my situation:

I had the carotid artery doppler, both sides, and my arteries were fine. No issues there.

Sadly, I am still having the pulsatile tinnitus, however. Nothing has changed, there. The wooshing is still only ever on my left side. It comes and goes. I can go a while without it, and then it comes back - gives me a headache, vertigo, nausea, and sometimes pain in my neck and ear region. Always in time with my heartbeat. The headaches I get are usually around my left temple, but sometimes smack bang in the middle of the head. I wouldn't call them severe, but they are painful regardless.

I have been trying to get an MRI / MRA, but my doctor just keeps saying not to worry about it, that I am young and just anxious.

I feel like something really isn't right, however. I'd at least like to rule out other potential causes, just to be safe.

Am seeing my cardiologist in a month for my annual check up, and will certainly raise the issue with him, but should I push to see a neurologist before then? Or prioritise an ENT?

Thanks again, folks, and sending sincere well wishes.

 

[stopthebeat]

Thanks so much for the replies.
Here's a quick update of my situation:

I had the carotid artery doppler, both sides, and my arteries were fine. No issues there.

Sadly, I am still having the pulsatile tinnitus, however. Nothing has changed, there. The wooshing is still only ever on my left side. It comes and goes. I can go a while without it, and then it comes back - gives me a headache, vertigo, nausea, and sometimes pain in my neck and ear region. Always in time with my heartbeat. The headaches I get are usually around my left temple, but sometimes smack bang in the middle of the head. I wouldn't call them severe, but they are painful regardless.

I have been trying to get an MRI / MRA, but my doctor just keeps saying not to worry about it, that I am young and just anxious.

I feel like something really isn't right, however. I'd at least like to rule out other potential causes, just to be safe.

Am seeing my cardiologist in a month for my annual check up, and will certainly raise the issue with him, but should I push to see a neurologist before then? Or prioritise an ENT?

Thanks again, folks, and sending sincere well wishes.

I am thinking that I may get a 2nd and or 3rd opinion just to be on the safe side.

You may look into seeing a neurotologist, which you may or may not already know is someone that deals with neurological disorders of the ear.

As far as you getting an MRI/MRA I would think that it is a good idea to rule anything out and if your current Dr doesn't think you should have one and if you continue to feel something isn't right I would remain persistent and, if you are able to do so, make an appointment on your own to see a different ENT (possibly one that has Neurotology experience), again, if you can do so without getting a referral. Depending on your insurance and where you are located you would need to investigate what or how you can go about this. But again if you feel something isn't right I would remain persistent.

I had my hearing checked at my local big box retailer and the tech that administered the test recommended I see an otolaryngologist that she highly regarded so I called and scheduled an appointment but he was not able to see me until much later, I went ahead and made the appointment. At the time I didn't realize that otolaryngologist was just the official name for ENT, and I really didn't want to see a regular ENT but it turned out that he was also a neurotologist.

In the meantime I was able to get an earlier appointment to see the ENT through my GPs office.

I showed the first ENT that I had recordings of the whooshing sound but he didn't want to hear it and when I said I wanted to rule out an anyerism he said I had been reading too much on the internet. As he proceeded to exam me he heard a bruit sound on my carotid which was why he did get me the carotid doppler.

As luck would have it the appointment to see the second ENT was the following Monday, I almost cancelled the appointment but I was unable to do so and I decided to visit with him, which as luck would have it turned out to be a great thing. It turned out to be one of the best experiences I've had with a Dr. I just got lucky, and he was fantastic. He was excited to hear the recording and was just very nice and he got me scheduled for the MRI/MRA.

So anyway long story, to get to the point that I was trying to make, it may take another Dr to take you seriously and get you scheduled to get an MRI/MRA.