Pulsatile tinnitus is the rhythmic perception of sound synchronized with your heartbeat, often described as a whooshing, thumping, or pulsing noise inside the ear. This differs from non-pulsatile tinnitus, which is typically a constant ringing or buzzing sound not tied to the pulse. When you are unwell with a cold, flu, or other systemic illness, the body undergoes temporary changes that amplify internal sounds. This experience is common during acute sickness because the mechanisms regulating pressure and sound are temporarily thrown off balance. While alarming, this symptom is usually a temporary side effect of the body fighting off an infection.
Physiological Link: Why Sickness Causes Pulsatile Tinnitus
Sickness often triggers two main physiological changes that work together to create the perception of pulsatile tinnitus. The first factor is the body’s generalized inflammatory response to infection, which can include a fever. Fever and infection increase the overall metabolic demand, prompting the heart to beat faster and push blood more forcefully through the vessels in a state known as hyperdynamic circulation. This accelerated and more turbulent blood flow creates a louder sound as it moves through the arteries and veins near the ear structure.
The second change involves the ear’s acoustic dampening system, which is compromised by inflammation and fluid buildup. The middle ear is normally separated from major blood vessels, like the carotid artery and jugular vein, by a small amount of tissue and air. When mucous membranes lining the Eustachian tube and middle ear swell due to infection, the air space can fill with fluid or mucus.
This fluid acts as a conductor, removing the normal air insulation that muffles internal body sounds and reducing the acoustic barrier. Consequently, the sounds of blood rushing through adjacent vessels become much more perceptible to the inner ear. The combination of louder, more turbulent blood flow and reduced acoustic dampening from congestion is what makes the pulse-like sound distinct during illness.
Specific Illnesses That Trigger the Sound
Acute upper respiratory infections, such as the common cold or influenza, are frequent triggers for pulsatile tinnitus due to their direct impact on the ear-nose-throat system. Sinusitis and severe head colds cause significant swelling and congestion in the nasal passages and throat. This inflammation can block the opening of the Eustachian tube, the narrow canal connecting the middle ear to the back of the throat.
When the Eustachian tube is blocked, pressure inside the middle ear cannot equalize with the outside atmosphere, leading to a feeling of fullness and reduced hearing acuity. This conductive hearing loss reduces the brain’s awareness of external sounds, which in turn causes the internal sounds of blood flow to seem louder by comparison. Systemic infections like the flu contribute further by raising the body’s temperature and causing general inflammation.
A fever, a common symptom of the flu, is a direct cause of the hyperdynamic circulation that increases blood flow velocity throughout the body. This elevated cardiac output makes the whooshing sound of blood moving past the ear’s vascular structures more pronounced and rhythmic. Allergies and post-nasal drip can also mimic this effect, as chronic irritation causes similar inflammation and fluid accumulation that leads to Eustachian tube dysfunction.
Immediate Relief and Management Strategies
The primary goal for managing pulsatile tinnitus caused by sickness is to reduce the congestion and inflammation driving the symptom. Hydration is a simple yet powerful strategy, as drinking plenty of fluids helps thin mucus, promoting drainage from the middle ear and sinuses. Over-the-counter decongestants or nasal steroid sprays can help shrink swollen nasal passages and open the Eustachian tube, but decongestant sprays should be used cautiously and for only a few days to prevent rebound congestion.
Managing systemic inflammation with appropriate over-the-counter fever reducers can also help lower the body’s overall blood flow velocity and reduce the intensity of the sound. When resting or sleeping, try elevating your head with an extra pillow or two, or by slightly inclining the mattress. This elevation uses gravity to assist with fluid drainage and can reduce vascular pressure in the head and neck, potentially lessening the volume of the pulsing sound.
Since the whooshing sound is often most noticeable in quiet environments, particularly at night, masking techniques can provide significant psychological relief. Using a sound machine, a fan, or playing gentle music at a low volume introduces a steady, non-alarming background noise. This distracts the brain from the internal pulse, making the symptom less intrusive and helping to improve sleep quality.
Identifying Warning Signs and When to Seek Care
In the context of a cold or flu, pulsatile tinnitus is almost always a temporary symptom that will resolve as the underlying infection clears. However, it is important to recognize when the symptom indicates a need for professional evaluation. If the pulsing sound persists for more than two weeks after all other cold or flu symptoms have fully resolved, a medical consultation is necessary to rule out other causes.
Unilateral pulsatile tinnitus, especially if it is not clearly tied to congestion, warrants attention. Seek immediate medical care if the sound is paired with severe or sudden neurological changes, such as intense headache, sudden hearing loss, changes in vision, or a feeling of weakness in the face or limbs. While sickness is a common, benign trigger, a doctor can perform a thorough examination to differentiate a temporary congestion-related issue from a rarer underlying vascular condition.