Pulsatile Tinnitus

Pulsatile Tinnitus Treatment in London

Hearing a rhythmic sound that matches your heartbeat can feel alarming, but pulsatile tinnitus is often linked to benign blood-flow changes or middle-ear factors rather than serious illness. Urgent audiovestibular assessment is needed if it starts suddenly, worsens rapidly, follows a head injury, or occurs with neurological symptoms, visual changes, or severe headache.

Rhythmic Vascular Signals

An Overview of Pulsatile Tinnitus

Pulsatile tinnitus is a form of tinnitus where the sound has a rhythmic quality, often in time with the heartbeat. People may notice a whooshing, thumping, or pulsing noise in one or both ears, or sometimes centrally in the head. Unlike more common tinnitus, this sound is usually linked to blood flow or pressure changes rather than the auditory system alone.

In many cases, pulsatile tinnitus relates to benign causes such as altered blood flow near the ear, changes in blood pressure, middle-ear conditions, or increased awareness of normal vascular sounds. However, because it reflects vascular activity, it always requires careful audiovestibular assessment to understand the source and exclude less common but important causes.

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Soydan Osman
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I was seen by audiologist and Dr Arun, they were attentive, caring and took time to listen and adaptations were made throughout the appointment to support my anxiety and claustrophobia. This made a significant difference and genuinely helped me through the audiology testing. I gave an explanation of my current symptoms to Dr Arun he displayed great listening, compassion and understanding. The treatment I received on the day has greatly improved my symptoms, the one reassuring thing is any follow up is required is knowing that I will be in safe hands. I received my clinic letter promptly. After care queries handled by the admin team was exceptional, prompt and helpful. Overall the service was impeccable.
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Diana Granados
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I had an outstanding experience with Harley Street Vestibular Clinic and cannot recommend them highly enough. I developed severe vertigo while visiting London, and it was an incredibly frightening experience as it was my first time ever experiencing dizziness like that. I called the clinic on a Saturday, fully expecting to leave a voicemail since they were closed. To my surprise, the office manager, Preeti, returned my call that same day. I was so grateful. She was kind, reassuring, and went above and beyond to arrange an appointment for me first thing on Monday. From the moment I arrived, the entire team was professional, efficient, and compassionate. They understood how urgent and distressing my symptoms were and made every effort to see me as quickly as possible. The vestibular audiologist was exceptional—she took the time to thoroughly evaluate me, clearly explain everything she was doing, answer every one of my questions, and perform the appropriate treatment. I never felt rushed, and her expertise immediately gave me confidence that I was in the right hands. The clinic was incredibly responsive, organized, and genuinely caring throughout the entire process. They turned what was a very scary situation into one where I felt supported and well cared for. I am truly thankful to Preeti and the entire team for their kindness, professionalism, and outstanding care. If you are experiencing vertigo, dizziness, or balance problems, I would not hesitate to recommend Harley Street Vestibular Clinic.
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erika thomazi
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Great positive experience!
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Carol Bunyan
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I could not fault my follow up appointment with Dr Aran and his team. He really does take the time to listen to your questions and really puts himself out to set you on the road to recovery . He genuinely seems interested in getting you better. I would highly recommend this practice.
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Ged Robinson
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Dr Benjamin Shaw was extremely thorough in his assessment of my recent attacks of vertigo. I have total confidence in his ability, once I have completed the further tests he has arranged at the Wimbledon clinic, to diagnose what is causing this issue with my health.
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Adrian Lowe
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I thoroughly recommend the Harley Street Audio Vestibular Clinic. I had an appointment with Dr Rudy Palaniappan who listened carefully to me, conducted a brilliant examination and explained everything to me with a future plan very clearly. I was really impressed!
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Dr Arun provided an excellent virtual consultation, took the time to understand symptoms and history and provided an initial diagnosis and treatment plan. It did not feel rushed or with any bias. Received comprehensive notes and summary promptly after the appointment. Would fully recommend.
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shahram zarafshan
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Dr. Arun Pajaniappane is a brilliant and expert doctor. He was also incredibly friendly, making for a truly excellent experience.
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I had an excellent consultation where both the doctor Arun Pajaniappane and the audiologist were highly professional, attentive, and genuinely responsive to my concerns. They listened carefully to my problems and explained everything clearly throughout the appointment. The procedures carried out were handled with great care and efficiency, which made me feel comfortable and well looked after. I very much appreciated their professionalism and patient-centred approach.

Pinpointing the Cause

Diagnosing Pulsatile Tinnitus

When to Get Checked

You should get assessed if pulsatile tinnitus starts suddenly, becomes constant, or is clearly synchronised with your heartbeat, particularly if it is heard in one ear only. New onset following head injury, infection, or surgery also warrants prompt audiovestibular review.

You should seek urgent assessment if it occurs with severe or unusual headache, visual disturbance, facial weakness, neurological symptoms, or raised blood pressure, or if the sound is progressively worsening. Early evaluation helps identify vascular causes and guides appropriate investigations and referrals.

Specialist audiovestibular assessment for harley street audiovestibular clinic at Harley AVM Harley Street London

How We Assess Pulsatile Tinnitus

At Harley Audiovestibular Clinic, assessment begins with extended time spent with a senior audiovestibular physician. We focus on understanding the rhythm, onset, and behaviour of the sound, how it relates to heartbeat or posture, and whether it changes with activity. We review hearing, balance, neurological symptoms, medical history, medications, and cardiovascular factors in detail.

Based on this consultation, we plan appropriate investigations. These may include comprehensive hearing tests, middle-ear assessment, and targeted audiovestibular examinations. Where needed, we recommend further medical tests or imaging. Our structured approach ensures concerns are addressed thoroughly and safely.

How To Assess Pulsatile Tinnitus At Harley Audiovestibular Clinic
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FAQS

Common Questions
for Pulsatile Tinnitus

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Find answers to pulsatile tinnitus, treatment options, and how our specialists can help.​ If you have any further queries, our team at Harley Street Audiovestibular Clinic is here and happy to help.

What Is Pulsatile Tinnitus?

Pulsatile tinnitus is usually not heard by others (like in objective tinnitus) and is typified by:

A beating or throbbing sound in the ear, often in sync with your pulse.

A sense of fullness or pressure inside the ear or ears.

Issues with your balance or outright dizziness.

Hearing loss in one or both ears.

Migraines or headaches.

Sounds that get louder when you lay down to sleep.

If you are experiencing any of the above, or a beating sound that gets louder during strenuous exercise, you may be experiencing pulsatile tinnitus. If so it is important that you seek professional help in order to obtain a proper diagnosis and to explore treatment options.

There are many more serious causes of pulsatile tinnitus compared to other types of tinnitus. Known causes include:

Brain and Neck Blood vessel aneurysms Arterio-venous malformation – an abnormal connection between blood vessels.

Hypertension (high blood pressure).

Problems with the thyroid gland.

Misshapen blood vessels in the ear.

Anaemia

Head and neck tumours.

Atherosclerosis (hardening of the arteries in the ear).

If you are diagnosed with pulsatile tinnitus, treatment will typically involve addressing the cause. Effective treatment of the cause can sometimes result in a cessation of the sounds. If the sound has not abated after the initial treatment additional treatments may be recommended, including:

A wearable sound generator.

White noise apps.

A combination of sound therapy and counselling known as “tinnitus retraining”.

Harley Street Specialists in Hearing, Dizziness & Balance

Specialist Care for Pulsatile Tinnitus

Every Pulsatile Tinnitus case is different. Your consultant will create a tailored plan to address your specific symptoms and lifestyle – when it started, how it affects your day, and which tests and treatments are right for you.

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