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Last updated: June 23, 2025View editorial policy

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Differential Diagnosis for Hearing Heartbeat in Left Ear

  • Single most likely diagnosis
    • Benign Intracranial Hypertension (BIH) or Idiopathic Intracranial Hypertension (IIH): This condition can cause pulsatile tinnitus, where patients may hear their heartbeat in one ear due to increased intracranial pressure. It's more common in young, obese women.
  • Other Likely diagnoses
    • Anemia: Reduced hemoglobin or red blood cell count can lead to increased blood flow, making heartbeats more audible, potentially causing pulsatile tinnitus.
    • Hyperthyroidism: An overactive thyroid gland can increase heart rate and blood flow, making heartbeats more noticeable.
    • Carotid Artery Stenosis: Narrowing of the carotid artery can cause turbulent blood flow, leading to pulsatile tinnitus.
    • Middle Ear Problems: Issues like a middle ear infection or a perforated eardrum can affect the transmission of sound, potentially making the heartbeat audible.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Giant Cell Arteritis: Inflammation of the arteries, particularly those in the head, can lead to pulsatile tinnitus and is a medical emergency due to the risk of vision loss.
    • Aortic Aneurysm or Dissection: Although rare, these conditions can cause pulsatile tinnitus and are life-threatening.
    • Glomus Tumor: A rare tumor of the middle ear or jugular vein can cause pulsatile tinnitus due to its vascular nature.
  • Rare diagnoses
    • Otosclerosis: A condition affecting the middle ear that can cause hearing loss and, in some cases, pulsatile tinnitus.
    • Paget's Disease of the Bone: A chronic condition that can affect the bones of the middle ear, leading to hearing loss and potentially pulsatile tinnitus.
    • Vascular Malformations: Abnormal formations of blood vessels near the ear can cause pulsatile tinnitus due to altered blood flow patterns.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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