Pulsatile or Vascular Tinnitus

[Warren Spencer]

Well I guess I will start this off with a simple definition. Pulsatile or vascular tinnitus is when the sound you hear , be it a ringing , thumping or whooshing in your head is in sync with your heart beat. For some it is painful for others its not, for some its constant for others it is not. One thing for sure is that if your T pulses with your heart beat you should seek medical attention. This may be a warning sign of something serious. The good news is that many cases it is very curable. Many things can effect your PT. Most noticeable will be diet , exersize , and stress. In my case it caused extreme anxiaty. Feel free to ask anything or just vent about your bad day. Remember , were all in this together and this site is here to help.

 

[Karen]

I'd like to hear from others who have pulsatile (vascular) tinnitus. Have you found any treatment that has been successful for you? Are you experiencing anxiety/stress over your condition? Is yours continuous, or intermittent?
What tests have you had? Would love to hear from others who are experiencing this condition.

As Warren (above) says, pulsatile tinnitus can be very curable, if the correct cause is found.

As for me, I'm still searching! Next, I'm going to try hearing aids/masking devices, and am even reading up on stapedotomy surgery, since I have otosclerosis. Does anyone know someone who has had stapedotomy or stapedectomy surgery? Was it successful?

 

[Lvc595]

Hi Karen. I have PT. Do you mean that all PT is vascular? I can tell you after reading the Whooshers site not many are cured.
Are you circulating your scans? I am trying to find other PT suffers in California. I'd like to know what doctors they have scene. Also can you tell me more about the stapedotomy surgery? Thanks

 

[SymphonSilencio]

A little off topic but can someone tell me briefly what pulsatile tinnitus really is? does it have somewhat of the same path of origin or is it like a Add-On to tinnitus and its various qualities of symptoms. Thanks in advance to anyone willing to answer.

 

[calin]

A little off topic but can someone tell me briefly what pulsatile tinnitus really is? does it have somewhat of the same path of origin or is it like a Add-On to tinnitus and its various qualities of symptoms. Thanks in advance to anyone willing to answer.

Yes, It is the tinnitus sounds that are in rhythm to your heart beat.

 

[Karen]

Hi, LCV595,
I can only speak for myself regarding pulsatile tinnitus, but it is also often referred to as "vascular tinnitus". As you've seen on Whooshers.com, there are many different causes for PT. Since it involves a "heartbeat" sound in the ear, it usually has something to do with the veins or arteries in some way. My doctor told me he thought mine was just a venous hum, and that I would probably have to live with it.

For me, the pulsating began two years ago, after I was put on blood pressure medicine. The blood pressure medicine did weird things to me, and I was put on a couple different types of drugs. I finally got myself off all the BP medications, and am now controlling it with natural remedies, such as fish oil, COQ10, etc. Not everyone has a reaction to BP medicines like I did, and those drugs are good and valuable for many people. But for me, this is the right course of action.

I have taken my scans to several doctors, and even sent them to a doctor in Baltimore that I'd heard of. However, I never did hear back from that doctor. I'm not in California, so I cannot help you there. The best bet might be to find a good neurotologist (they specialize in a combination of neurology and otology) in your area. I believe there is a link on Whooshers.com to neurotologists in each U.S. state. Or, you could begin with an ENT, and he/she might then refer you to a specialist in your area.

A stapedectomy is a type of surgery for those who have otosclerosis (calcified buildup on the stapes bone in the ear), that would cause conductive hearing loss. The surgeon removes the stapes bone and inserts a prosthetic titanium "bone" in its place. The purpose of this surgery is to improve hearing, NOT to get rid of tinnitus or pulsatile tinnitus.

There is also a stapedotomy, wherein the surgeon doesn't actually remove the bone. I think the surgeon determines after he/she begins the procedure which type of surgery is best.

Some people have very good outcomes after stapes surgery, as regards improved hearing. I've only read about one person whose pulsatile tinnitus appears to have stopped after this surgery, so I wouldn't put too much stock in this as a possible cure.

 

[calin]

LCV595

Karen and I both have vascular tinnitus... at least that is what my ENT said. I am supposed to do a carotid scan and an MRI. My regular doc says that she hears normal flow of blood tin my neck and heart. The ENT also said he heart a heart murmur. No one else has though. My EKGs don't show it.

Mine pulses with my heart beat.

 

[SymphonSilencio]

The problem I'm thinking of here after reading a little bit about pulsatile T from the websites mentioned and others I've found is that they are considered different in terms of one being objective and the other being subjective and that Pulsatile is linked to more serious health conditions.

I think the most important thing here is to make an absolute distinction between the 2 so that we can have a better front on both. A separate section for pulsatile would be nice but what I'm really wondering is if there is any correlation between what causes tinnitus tinnitus and pulsatile tinnitus. First step to figuring out anything medical related is understanding the etiology as we all know.

All I can ask in this situation for all the pulsatile T people in here, of the recommendations common and not so common to remedy, lessen, make less obvious do they work about the same for you or less or more. Does imbibing alcohol make your T elevated. Does high volume sound overtime aggravate T for you guys or make it higher permanently? Do drugs in general make your tinnitus worse?

I may not know about or have pulsatile myself but I truly would like to keep myself aware of such things as I still consider it "in the same boat" as myself if not worse which I'm sure it is for many.

 

[Karen]

Well-said, SymphonSilencio! You are right that the two are in different categories. I got both my loud ringing and my pulsating at the same time, and will try to answer your questions about the effects of both.

1. Alcohol or caffeine - I've pretty much gotten off caffeine since all this started, and never really drink alcohol; however, the few times I've had some caffeine recently, I haven't noticed any change in my ringing tinnitus or my pulsating tinnitus.

2. High-volume sound - Yes, that affects both my ringing and pulsating. What's bad about the pulsating is that when there is a loud sound, or a sound at a certain pitch, it REALLY aggravates the pulsating a lot! Until recently, I could hardly bear to watch televison, because it made me feel like my whole head was vibrating. Listening to sound therapy on an MP3 player while watching t.v. helps me to be able to tolerate the sound vibrations.

3. Drugs - I don't take any drugs now, except Synthroid, and it doesn't affect my tinnitus. However, blood pressure drugs really did. That's how my pulsating got started. At the time, I had never heard of pulsating tinnitus, and I thought my head was pounding. Didn't know it was actually coming from my right ear!

4. Blood pressure - I had a lot of problems with blood pressure when I first got my bad tinnitus/pulsating, and after I got off the blood pressure drugs, my blood pressure went up and down for months! That made my ringing and pulsating into absolute roaring and pounding for awhile. I don't have that extreme situation any more, thank goodness! So, yes, blood pressure definitely affects both pulsating and ringing for me.

5. Sleep - I feel that I could sleep through ringing tinnitus. But the pulsating is another story! It is really hard to settle down and go to sleep at night, because you can hear and feel the pulsating throughout your body (or, at least, that's how it affects me).

Hope I've helped to answer some of your questions about the two very different types of tinnitus. Are they somehow linked? Well, it is possible. I've read that people who have a thyroid condition, like me, can develop pulsating due to increased blood flow in the veins.

It would be interesting to hear from others as to how both types of T affect them.

 

[SymphonSilencio]

2. Are you the type that is startled, annoyed, or distracted easily? I'm only asking because its my reasoning that some people who experienced tinnitus aggravation from loud sounds only do so because it causes them stress they may not associate with being in that environment. For others it may simply aggravate it for the duration and some time (30 minutes to a couple hours afterwards) or may be a permanent thing like in my case because more trauma was caused to the ear somehow.

4. The fact that your on same footing with myself in terms of how you got pulsatile vs how I got regular T (categorically speaking) gives me reason to believe that they can still be undone the same way at least in our medication induced cases. The biggest clue you gave me is the fact you already had some hearing loss and mild tinnitus to begin with. From my observations you were already a risk factor to anything you added to your regimen pill wise. I dont like going overboard with "every pill is toxic to the ear" but im starting to learn that in many cases it is and its the body's ability to process and handle the side effects (some of us have better chemistry than others) of the meds that decides what we are more and less susceptible to. Theres many cases around the world concerning kids getting significant hearing loss from frequent use of antibiotics. You dont need to get T from meds to know it did you wrong. We just happen to be on the shorter end of the stick.

5. See thats a bit of an issue for me to get. What I'm asking myself is are you hearing your T and the Pulsatile together sort of like 2 different streams or are you hearing your pre T in your ear and you feel the vibration from your pulsatile or are they simply synonymous with each other at this point. I know this sounds confusing but perhaps it would help if you could tell me was there any real overall change in tonality or quality of sound once you got the pulsatile.

In your case it seems linked still. Many people go on hypertensive meds yet we have a statistic of 3 percent of the population that get T have pulsatile as they say. My best bet is that perhaps taking the blood pressure was a trigger of sorts. In my simple mind I believe it simply damaged/warped your ear system more giving you that quality. On the other hand you could have a House M.D. sort of situation where taking it acted as a catalyst to something not so good happening in the body and your body's way of telling you was to go and stay in pulsatile T mode. Obviously I'm no expert and I can see youve gone through and researched many treatments and surgeries of various kinds. Your own medical history and your families medical history might be the key in finding the pandora's box that the hypertensive med opened. I know this probably wont help much but Im brainstorming as thats what I like to do.

If you can absolutely rule out the hypertensive med that I can firmly stick with the thyroid explanation. The problem with getting T or Pulsatile is that it isnt gradual in any sort of way. You either got it or didnt get it and that makes it difficult to pin the exact cause of it in many situations.

I dont know much but my father's doctor is basically one of the main factors of his early demise. One of my mother's friends was put on on a liver medication of some kind (dunno if it was that but anyway) and she ended up being unable to breath depending on a mask and a tank to make it through the night. My grandfather died in the HOSPITAL for high blood pressure as he wasnt monitored and treated properly. I know many doctors want to help but the system wants our money and care for little else in my opinion.

 

[Karen]

To answer your questions, I'll go in numerical order:

2. No, I'm not that easily startled. I think the main problem is that certain sounds make my already pulsating ear pulsate even more. It feels like a vibration, and sounds of a certain pitch make it seem worse.

4. Yep, I certainly believe in ototoxicity now! Wish I'd known about ototoxic drugs before all this started. I'm sure you feel the same way. There are plenty of lists on the internet that specify which drugs are most likely to be ototoxic. We patients have to look out for ourselves, because most doctors aren't going to.

5. It's hard to describe, but both are going on at the same time, as two different streams. One is usually more noticeable than the other. For example, I usually notice the ringing more when I'm up and busy, and the pulsating more when I'm in a quiet place or trying to sleep. Right now, however, I'm hearing a pounding drum-beat undertone, and a high-pitched constant ringing at the same time. For some reason, mine is worse in the evening. Do you have a time of day when yours is worse or better?

I am sure that the BP meds are what set off my severe tinnnitus and pulsating. However, there could be some sort of chemical imbalance in the body that keeps it going. I'm still trying to figure it all out. I keep hoping that, in time, the body will right itself and the tinnitus will lessen. I hope that for you, too!

 

[Roger Cloutier]

Well I guess I will start this off with a simple definition. Pulsatile or vascular tinnitus is when the sound you hear , be it a ringing , thumping or whooshing in your head is in sync with your heart beat. For some it is painful for others its not, for some its constant for others it is not. One thing for sure is that if your T pulses with your heart beat you should seek medical attention. This may be a warning sign of something serious. The good news is that many cases it is very curable. Many things can effect your PT. Most noticeable will be diet , exersize , and stress. In my case it caused extreme anxiaty. Feel free to ask anything or just vent about your bad day. Remember , were all in this together and this site is here to help.

Hi Warren, I've been on the site for approximately 2 years now. My understanding of PT was obtained through a process of reduction. I noticed that my symptoms where less similar to the regular tinnitus and were more aligned with PT. I had a humming sound with a higher tone in my right ear. The lower sound is 260 Hz and the higher tone eventually went away to be replaced by the whooshing, but only after a series of cracks and pops.
I also noticed how pressing on various parts of my head ''seemed'' to alleviate the symptoms. I noticed that my humming sound was also aligned with my heart beat, ''nearly most of the time. The symptoms are at their quietest when I am standing. My vascular surgeon said that this makes sense, as my blood flow is less at this point.
One ENT doctor suggested I increase my high blood pressure medication, Ramipril. I've done so, in an incremental fashion, but this hasn't really had an effect.
I've had an MRI and CT angio-scan which reavealed a dehiscence in my jugular bulb. The 2 ENT doctors that I have seen said that ''Hypo-Tympanic Re-surfacing'' would not help my condition. Anyone saying so probably experienced a ''placebo effect''. Hey I would settle for that !
Anyways, all the best, at this time of the year.

Roger

 

[sakrt]

I'm new on this site & finished adding my "intro" part in other category. It seems, I'm the only deaf (sensiorneural) one here? and I did have the ability to hear my heartbeat clearly most of my life. Now w/ the tinnitus added, it appears they're 2 separate issues but still interconnnected. In some cases it's dishiscence. I've learnt many have superior canal dishiscence which is one reason of these symptoms. Mine is abit more complex but I've never had my tinnitus evaluated w/ the heartbeat. Is the only way to do this is thru an angio - scan to check the arteries? The ct/mri do not show this. I've also had low vit d deficiency for 3 yrs even w/ double supplements of the stuff which is questionable as well.

 

[sakrt]

My mum had otosclerosis (often runs in families) from women after having children. She started losing her hearing and had the stapedotomy which revived her hearing to normal. She did not have tinnitus though. She's had it done 2 more times after hitting her head severely and each time was successful. Key: a good Dr. to perform it.

Hi, LCV595,
I can only speak for myself regarding pulsatile tinnitus, but it is also often referred to as "vascular tinnitus". As you've seen on Whooshers.com, there are many different causes for PT. Since it involves a "heartbeat" sound in the ear, it usually has something to do with the veins or arteries in some way. My doctor told me he thought mine was just a venous hum, and that I would probably have to live with it.

For me, the pulsating began two years ago, after I was put on blood pressure medicine. The blood pressure medicine did weird things to me, and I was put on a couple different types of drugs. I finally got myself off all the BP medications, and am now controlling it with natural remedies, such as fish oil, COQ10, etc. Not everyone has a reaction to BP medicines like I did, and those drugs are good and valuable for many people. But for me, this is the right course of action.

I have taken my scans to several doctors, and even sent them to a doctor in Baltimore that I'd heard of. However, I never did hear back from that doctor. I'm not in California, so I cannot help you there. The best bet might be to find a good neurotologist (they specialize in a combination of neurology and otology) in your area. I believe there is a link on Whooshers.com to neurotologists in each U.S. state. Or, you could begin with an ENT, and he/she might then refer you to a specialist in your area.

A stapedectomy is a type of surgery for those who have otosclerosis (calcified buildup on the stapes bone in the ear), that would cause conductive hearing loss. The surgeon removes the stapes bone and inserts a prosthetic titanium "bone" in its place. The purpose of this surgery is to improve hearing, NOT to get rid of tinnitus or pulsatile tinnitus.

There is also a stapedotomy, wherein the surgeon doesn't actually remove the bone. I think the surgeon determines after he/she begins the procedure which type of surgery is best.

Some people have very good outcomes after stapes surgery, as regards improved hearing. I've only read about one person whose pulsatile tinnitus appears to have stopped after this surgery, so I wouldn't put too much stock in this as a possible cure.

 

[Karen]

Hi, Kasart,

Have you been checked to determine whether or not you have otosclerosis? I assume you don't since you have sensorineural hearing loss (as opposed to conductive hearing loss). Just wondering if you'd benefit from discussing stapedectomy with your doctor.

Also, from what I've heard, you're right that you'll need an additional (angio) test to tell if you have superior canal dehiscence. Do you have a good neurotologist who could order such a test for you?

I don't know if there are other deaf people on this board; I haven't heard from any others myself.

Yes, a vitamin D deficiency could perhaps make your tinnitus worse. I've been taking a vitamin D supplement for awhile myself, and I believe it has helped. I still have pulsatile tinnitus, but it is less bothersome now than it was a year ago.

I wish you well, and am glad you joined us on Tinnitus Talk!

 

[terrihastinnitus]

I'm new on this site & finished adding my "intro" part in other category. It seems, I'm the only deaf (sensiorneural) one here? and I did have the ability to hear my heartbeat clearly most of my life. Now w/ the tinnitus added, it appears they're 2 separate issues but still interconnnected. In some cases it's dishiscence. I've learnt many have superior canal dishiscence which is one reason of these symptoms. Mine is abit more complex but I've never had my tinnitus evaluated w/ the heartbeat. Is the only way to do this is thru an angio - scan to check the arteries? The ct/mri do not show this. I've also had low vit d deficiency for 3 yrs even w/ double supplements of the stuff which is questionable as well.

hello there. sorry to say, but you're not the only one on the forum who is deaf in the ear they have tinnitus.

 

[sakrt]

Today I have asked my Neuro-oto. for tests (which should have been done prior my CI) for an MRA. Discovered I now have to get the "magnet" off my skull (under skin) out first to do this. You'd think an ENT Dr. would inquire into a few options/tests before drastic surgery, which has me totally deafened and depressed. I require ENG/VNG tests etc. for the balance issues.

Does anyone have addt'l inner ear issues along with their pulsatile tinnitus such as Tullios syndrome or dehiscence (SDC) etc? From my understanding, I do not have otosclerosis even though I mentioned the family history. I am not sure if it would occur w/ people with sensiorneural deafness - I am sure it could but it's not my reason.
I do take a lot of natural supplements to try and -help- my condition.

 

[sakrt]

hello there. sorry to say, but you're not the only one on the forum who is deaf in the ear they have tinnitus.

I'm glad to hear that -seriously. Because more info. could be provided about tinnitus from both conductive and sensiorneural (90 db +) hearing-loss sufferers.

 

[sakrt]

The Dr. who quickly put in my cochlear implant that made my pulsatile tinnitus and depression worse. I asked him recently for an MRA to check my arteries. I also have chronic sinus disease and thought maybe somehow I have some abnormalcy to veins near my ear or sinuses that's causing it etc. He told me "Pulsatile tinnitus and awareness of various body sounds is normal in patients with 3rd window symptoms. She had a CI so a MRI is not a good idea and interventional radiology studies such as catheter angiography is an option but does incur a small risk for stroke. I would not recommend it". What is the difference between an MRI and a non-invasive MRA? Also CTA? I didn't ask yet for the "catheter" one. Are there other options or ways to check for pulsatile tinnitus?

 

[Karen]

Hi, Kasart,

I've had an MRI and an MRA for pulsatile tinnitus. During the last part of the imaging, they inserted gadolinium dye into my veins. I didn't have any problem with it, and the results of my tests were negative.

A CTA is a CT scan with iodine contrast dye. It is supposed to show areas not shown on the MRI (I haven't had this test myself).

I understand that most doctors believe that a catheter angiogram is the "gold standard" in testing for pulsatile tinnitus. However, there is a small risk for stroke.

I later learned that there is also an MRV test, and that people suggest you have both an MRA and an MRV at the same time. Wish I'd known that when I had the tests! There may be other tests that would be useful in diagnosing the cause of pulsatile tinnitus, but these tests are the most common.

 

[sakrt]

Just thinking aloud - You'd think a Dr. would complement an MRI along with MRA/MRV at the same time through one appt. to rule out all issues (if it only just requires injecting contrast dye)? Rather than do them separately at later times? (more costly, more wasted time). I am considering the "angioplasty -catheter" one and would like to ask any one here if they experienced it. Did it make a big difference than just using their MRA alone?