What Does Pulsatile Tinnitus Sound Like? Real Examples You Can Compare

You are sitting in a quiet room and hear that unusual sound, which has a rhythm. You may ask yourself, “What does pulsatile tinnitus sound like?” And why do I find this to be so much different than typical ringing? The short answer is it usually matches your heart beat, and it will go away for a while, come back, and repeat.

I understand how difficult it is to describe or put into words these unusual sounds. Therefore, this guide will remain straightforward. You will receive real world examples of the types of sounds you may experience (whoosh, thump, click, flutter), as well as quick signs that indicate whether it is time to seek medical attention.

What does pulsatile tinnitus sound like in real life? Common sound patterns you can match

The first thing to think about when trying to determine what does pulsatile tinnitus sound like is rhythm. Most people say their tinnitus has a “rhythmic” quality, sounding like the beating of a heart – like having a personal metronome in your head that you did not ask for. This may be quiet enough to ignore throughout the day, but can be very loud and distracting at night when there is no background noise in the house. Your tinnitus may be heard in one ear, both ears, or it may feel as if it is “inside your head,” rather than being localized on either side.

Another important aspect to consider when thinking about what does pulsa¬tile tinnitus sound like is how consistent it is. There are days when it is present for hours, while other days it seems to come and go in response to your position, stress levels, or nasal congestion level.

One way to help identify the pattern of your tinnitus is to stop focusing on finding a good name for the sound and focus on comparing the different rhythms. Below is the most common sound “flavors” reported by people experiencing pulsatile tinnitus and are all associated with a heartbeat-like rhythmic sound (whoosh-whoosh, thump-thump).

The classic “whooshing” sound, like wind or a sonogram

Many people report that their pulsatile tinnitus sounds like a smooth “whoosh-whoosh” that rises and falls with each pulse; a gentle, sweeping, oceanic rush of wind in a seashell that pulses to the rhythm of the heart; or a low-rushing sound of water draining from a distant washing machine, yet this sound appears to be linked to the heart’s rhythm rather than the constant speed of the washing machine.

A few individuals describe their tinnitus as sounding similar to a sonar sweep, a soft, slow “shhh… shhh… shhh,” like a slow, scanning motion; while others have reported that the sound is similar to a blood flow, a full-bodied, warm sensation that seems to be closer to them than it actually is.

The initial stages of the condition are often subtle (it may feel like it is on the other side of the wall), yet once an individual becomes aware of the whooshing, it can become very apparent, particularly if the person lies down.

If the question remains “what does pulsatile tinnitus sound like?” listen for whether the whooshing has a distinct up-and-down pattern; some individuals will note that the sound changes with light pressure to the side of the neck, turning the head, or changing position.

Individuals are not attempting to self-diagnose themselves by using such techniques; they are merely noting if the sound acts in conjunction with the heart’s pulse rather than being a steady tone.

A “thumping” or “drumming” beat that feels like it is inside your ear

The sound of pulsatile tinnitus is sometimes not the sound of moving air or water. Sometimes, it’s the sound of an impact. A low “thump-thump” which physically feels as if you are being tapped on by something inside your ear. For example, if you have ever been near a microphone and someone was tapping their finger on the microphone, that muffled, close-in tap, it can feel somewhat like this, just timed to the beat of your heart.

Sometimes people say it sounds like a bass drum behind a wall. The pulse isn’t defined sharply, it’s simply felt as being there. Or like the creaking of the floor above your bedroom as you try to fall asleep, a gentle but constant thumping that draws your attention back again and again.

One reason why it may seem louder at night is because the room is quieter than it would be during the day, and your brain is less distracted. So, when you lie in bed listening to it, it can be very easy to get caught up in the “is this dangerous?” cycle. Simply go back to describing the question, “what does my pulsatile tinnitus sound like to me right now, a thump, a rush, etc.?”, and name it clearly. Clearly naming your experience will allow you to better describe your experience in the future, and to calm yourself down about it in the present.

Clicking, fluttering, or “helicopter” sounds that still follow a pulse

Not all individuals are able to describe their Tinnitus as either a smooth whoosh or a heavy thud. Many report hearing a quick flutter of sound; such as a small flag flapping in the wind. Others state that they hear a clicking that comes at a steady rate or in a rhythmic pattern; some describe this sound as sounding like a “card in bicycle spokes” which can cause an apparent rapidity and slowness in the rattling sound.

One common analogy for describing Tinnitus that fits the above descriptions is the sound of a distant helicopter; however, it is not the sound of the helicopter directly overhead (which sounds like a repetitive chop-chop) but rather the sound of the helicopter as it flies by in the distance, which provides a gentle rhythmic flutter of sound that continues to repeat.

The distinguishing feature of pulsatile Tinnitus is the relationship between the timing of the clicks or flutter and the individual’s heartbeats. If the individual reports that the clicking or flutter occurs at the same time each day/week/month, it could indicate that the clicking or flutter is related to the individual’s pulse and therefore falls within the definition of pulsatile Tinnitus.

If you are attempting to describe your Tinnitus experience verbally, keep the primary focus of your description on the central question; i.e., what does your body sound like when it hears pulsatile Tinnitus?

An example would be, I have a flutter that follows my pulse, whereas others may describe a random pop of noise that has no discernable rhythm. This rhythmic nature of your Tinnitus will assist in providing your description to a clinician so that he/she may identify whether or not your Tinnitus is consistent with a diagnosis of Pulsatile Tinnitus.

Quick ways to tell pulsatile tinnitus apart from regular ringing

Regular tinnitus is generally perceived as a constant, persistent ring or buzz; however, it may also be perceived as a steady hiss or an annoying whine. On the other hand, pulsatile tinnitus, due to its rhythmic nature, can be felt as if it has a “pulse” to it (i.e., it beats with your heart). Therefore, many individuals are interested in determining what does pulsatile tinnitus sound like since it rarely matches the “ringing” description.

In terms of equipment, there is no requirement to use any to note some of the very basic differences in tinnitus. When trying to determine whether or not the tinnitus is pulsatile tinnitus, the focus should be on the timing, triggers, and how the sound of the tinnitus will react to the different speeds of your body. I have personally discovered that after just one week of paying attention to rhythm, vague panic turns into clear information.

Does it match your heartbeat? The sync test you can do in seconds

A basic comparison of the rhythm of the Tinnitus Sound to your pulse is to compare the two. You can feel your pulse at your wrist (radial artery) or at your neck (carotid artery), and see if the sound matches your pulse. If it does, this “beat-to-beat” correspondence may help explain why some people experience their pulsatile tinnitus as “pulsating”.

Most true pulse-linked tinnitus patterns follow changes in an individual’s bodily rhythms. For example, if you walk up the stairs, are under stress, or are busy rushing around, your heart rate will increase. Many individuals report that their tinnitus pattern follows the speed of their heart as well; thus, as your heart increases its beat-per-minute rate while you are active, the tinnitus pattern increases in speed, and decreases when you slow down, allowing you to rest. This “matches your tempo” feeling is another way many describe what pulsatile tinnitus feels like in everyday living.

It is common for there to be times when the pattern of the tinnitus sound is difficult to determine. Sometimes, due to the quietness of the environment, the sound of the tinnitus is faint, or there is enough background noise that the pattern cannot be discerned. Do not force yourself to attempt to identify the sound. Your purpose should be observation only.

What changes it, position, pressure, exercise, or silence

In addition to its typical characteristics, one of the most practical differences about Pulsatile Tinnitus is that it can be very reactive. So when you are tracking what does pulsatile tinnitus sound like, take note if the sound varies from day-to-day (not in order for you to test or compare yourself) because you are simply experiencing a part of your daily life.

Some common items that people have reported can affect the pulsing sound of Pulsatile Tinnitus include:

• Sitting or lying down;
• Walking and bending in order to tie shoelaces;
• Turning your head sideways to look for something behind you;
• After working out or walking rapidly;
• Consuming large amounts of caffeine or alcohol;
• Eating large meals;
• Experiencing nasal congestion due to an upper respiratory infection;
• Feeling stressed and anxious;
• At night when it is quiet, and there are no other sounds around.

It is unusual, yet also very informative that you might notice a “ringing”, “tone,” or “beeping” type of sound while moving your body around.

Typically, a consistent or “steady” ringing of tinnitus will not respond to your body position. The tinnitus that has the potential to change (or “move”) based upon how you sit, stand, etc., is called “pulsatile.”

Therefore, it is common for patients who experience this to inquire about what does pulsatile tinnitus sound like. In some cases, the pulsatile tinnitus will create a sensation that the tinnitus is “alive” and/or moving versus being stationary.

Document when you first experience the tinnitus. Document the positions of your body when the tinnitus occurs. Document the volume of the tinnitus relative to your activity levels and periods of rest. This way, you will have even more insight into your tinnitus and be able to develop a much better understanding of it without having to guess.

When the sound is a red flag, and what to do next

Most descriptions of sounds describe sounds only; however, any new heart-beat-synchronized sound should be considered due to the possibility it may be related to some medical condition which requires further evaluation. Stating “what does pulsatile tinnitus sound like” may assist by broadening your question slightly to “what else is happening in my body at the same time?”

The purpose here is not to cause alarm. The purpose is to provide you with an acceptable threshold for taking action. I would prefer that you seek evaluation and receive the diagnosis of being healthy than spend time alone with a sound that causes you anxiety.

Get urgent help if you notice these symptoms with the pulsing sound

Seek immediate medical attention if your pulsatile tinnitus is accompanied by any of the following:

• Sudden hearing loss – especially in one ear.
• An unusual headache that has become very painful.
• Weakness, numbness, or a drooping face on one side of your body.
• You faint or nearly faint.
• Changes in your vision (double vision, blurred vision or sudden blindness).
• Dizziness or vertigo that is either severe or persists.
• Trouble speaking or confusion.
• Chest pain.
• If you’ve had a recent injury (head or neck), and have developed a new, extremely loud one sided pulse, seek medical attention immediately.

In the above circumstances do not wait for it to go away; seek immediate medical assistance. If you are still trying to determine what does pulsatile tinnitus sound like and you have some of the red flag symptomology, then consider this a true medical emergency and seek immediate treatment.

How to prepare for your appointment so you get answers faster

Getting ready can help if your symptoms don’t require immediate treatment, but you want answers. Describing your tinnitus is often difficult in an unstructured environment, especially under stress or time constraints. Record as much information as possible to bring with you.

A basic checklist to track:

• What was your onset like (gradual vs sudden?
• Which side of your head (left, right, “in the middle” or both)
• Does it stay constant or is it on and off
• Do you think it sounds most like a whoosh, thump, click, flutter.
• What do you find makes your tinnitus louder or softer (your position, are you exercising, are you stressed out, is your sinuses congested).
• Have you had any recent infections, allergies flaring up or any issues with your sinuses.
• Are you taking any new medication or supplements.
• Is there any history of high blood pressure (do you know yours).
• How has your sleep quality been as well as how stressful have things been for you recently.
• Please provide me a 1 week log of when you experienced your symptoms (time, how long, intensity 1-10)

Depending upon what you tell them and what they find during the examination, clinicians will consider whether testing (hearing test, blood pressure test) or imaging (and possibly other tests), etc. would be reasonable. While none of this is guaranteed to provide a definitive diagnosis, it represents a logical step in seeking resolution.

Conclusion

Pulsatile tinnitus typically falls into three categories: a rushing whoosh-whoosh; a thumping, drumming beat; or a clicking, fluttering rhythm which mimics the flow of a pulse.

The key dividing line is whether the sound synchronizes with your heart’s beat, and how much the sound changes with the variations of your heart rate.

If you are still wondering about what sounds like pulsatile tinnitus, you now have some examples of what it may sound like to help guide you as well as ways to describe your own pattern(s) without having to speculate as to why they occur. For at least a week, track it for possible signs of red flags, and discuss it with a clinician if the sound is new, occurs on one side, has worsened, or causes you distress. Even though the sound seems to be intruding upon you, your attention to it is a form of control.