Discussions By Condition: I cannot get a diagnosis.

Pounding heartbeat in right ear with exercise.

Posted In: I cannot get a diagnosis. 4 Replies
  • Posted By: Billytogan
  • June 20, 2009
  • 06:47 PM

I have a pounding in my right ear when I exercise. I notice that it stops when I look up, put pressure on my right artery, or stop exercising. So I know its from increased blood flow thats making the noise because it also goes with my pulse. I had a lump near my right carotid artery at the same time so I thought that might be it. I went to the doctor and they did an ultrasound of only my right carotid artery. It came back fine. Now I am worried. I read that if an artery is narrowing it would make the other local arteries pump more blood thus making that noise. Wouldnt it make sense that if my left carotid artery was narrowing that it would make noise in my right ear? Or are they talking about how if say my right internal artery is narrowing more would flow through the right external artery and not the left side?

Sometimes when I am laying down and I take a really deep breath I can feel blood flow through the back of my head for a few seconds.

I also had a lump near my right artery so I had a CAT scan of my neck. Would they have checked for narrowing arteries or are they just focused on lumps and masses?

I am so nervous I am going to have a stroke or something at any second. My parents say its nothing(I dont blame them because I have major anxiety and have been to many doctors, but none have checked my left carotid artery) . So to put my mind at some ease I tell myself " that if my left artery was seriously blocked that I would be having this thumping noise even without exercise?" Does this sound reasonable or should it only make the noise when exercising?

Thanks

p.s. Could this be a rare symptom of TMJ? I notice I can hear/feel blood flow on my right carotid artery. If I intentionally make a bruit by putting pressure on my right carotid artery I can feel the vibration in my ear. Also If while I am exercising and I am hearing this pounding heartbeat if I push my jaw forward it stops

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4 Replies:

  • Okay, you need to relax. This is known as pulsatile tinnitus and is harmless. It can occur if the musculature proximal to the auditory canal and tympanic membrane is strained or under tension, resulting in a capture of the sound of blood flow from the internal carotid artery. It can also occur if the auditory canal itself is swollen due to inflammation. Changes in body position typically reduce the amplification or cause it to go away altogether. It does not suggest elevated blood pressure or impending vascular event of any type. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • Okay, you need to relax. This is known as pulsatile tinnitus and is harmless. It can occur if the musculature proximal to the auditory canal and tympanic membrane is strained or under tension, resulting in a capture of the sound of blood flow from the internal carotid artery. It can also occur if the auditory canal itself is swollen due to inflammation. Changes in body position typically reduce the amplification or cause it to go away altogether. It does not suggest elevated blood pressure or impending vascular event of any type. Best regards, J Cottle, MD I want to start by saying thank you you are very kind. But from all the I read EVERYWHERE suggests that pulsatile tinnitus is vascular origin. I am just wondering if my left artery is narrowed would it increase the blood flow in my right artery? WHy is it only happening in one ear? Could it be related to tmj? Because my right ear clicks when I open my jaw and if I create a bruit from pressure with my finger on my right artery my right ear vibrates from the bruit.this has been going on for months.
    Billytogan 2 Replies Flag this Response
  • If you are having symptoms only with exercise and they go away with rest, it may be that it is minor or of little significance (depending on your age). Nevertheless, a complaint of pulsatile tinnitus (PT) should not be taken lightly.First, have you ever noticed this at rest? Second, has your doctor used his/her stethoscope to listen for an audible bruit around your ear (yes, tragically, I have known doctors who do not use this simplest of instruments and proceed directly to dopplers and CTs) head, and neck? Has your doctor auscultated your carotids? This would be the simplest way to make out any carotid stenosis. In your case, since an ultrasound was normal I would say it is not a problem of carotid stenosis, and it is very unlikely if anything will be found on your left carotid. Your CT neck rules out any lumps or structural problems in your neck, which to my knowledge are not related to PT.You need to tell your doctor if your symptoms occur only with exercise or at rest, how long they last, are there any associated symptoms (headache, dizziness, visual problems, dizziness, problems walking etc.) What is the quality of the sound (beating, whooshing, squeaking, clicking)? Does the pulsation increase when you sit up, lie down, etc. Is the sound in your ear truly consistent with your pulse (suggesting vascular cause) or not (suggested eustachian tube or ear muscle related cause). Is your PT subjective (not audible to physician with steth/Toynbee tube) or objective (your physician can hear it). If your symptoms continue to increase I would suggest you consult an otologist (preferably university based). They might order a CT temporal bone and CT angiogram to look for problems with blood vessels near your ear and in your head and also with sinuses (large draining veins) in the head. An angiogram may be necessary to rule out a condition called a dural arteriovenous fistula, which is an abnormal connection between arteries and veins or sinuses.Systemic causes your physician may want to look for are high BP, thyroid function etc. A condition called idiopathic intracranial hypertension may also be associated with PT. It is possible a cause may not be found despite appropriate testing.As far as TMJ syndrome is concerned, I am unsure how well clinically characterized this condition is (in particular, in terms of its relation to PT), so I will not comment on this.Again, hopefully your problem is not serious, but consult with your doctor.Hopefully you find this helpful, and wish you all the best.
    Anonymous 42789 Replies Flag this Response
  • Hi, your symptoms may be an indication of pulsatile tinnitus. As a sufferer myself, I agree that "calming down" about it is helpful (as one of the responders said--easier said than done, by the way), I do not agree that it is absolutely not an indication that something else is wrong. It actually can be an indication that something is wrong, so you should see a doctor who is familiar with pulsatile tinnitus. There are many, many causes of pulsatile tinnitus; some are benign and others are not. The good news is that unlike regular tinnitus, it is often possible to find the cause of the PT and then treat it. Sometimes the cause is not found. Pulsatile tinnitus is not as common as regular tinnitus, and many people, including some doctors, tend to clump the two groups of tinnitus sufferers into one bunch without ruling out some of the known causes of pulsatile tinnitus. Know that you're not alone. There are a lot of us "whooshers" out there. For a variety of reasons we hear a heartbeat noise. If you do a search for whooshers you will find more info and support from other sufferers of pulsatile tinnitus, including tips to deal with it. Hang in there.
    Anonymous 42789 Replies
    • September 26, 2009
    • 04:38 PM
    • 0
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