What causes a patient to experience audible heartbeat (palpitations) in their ears, particularly in quiet environments, such as at night?

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Last updated: April 23, 2025View editorial policy

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From the Guidelines

Hearing your heartbeat in your ears, especially in quiet environments like when going to bed at night, is typically caused by a condition called pulsatile tinnitus, which is often associated with high blood pressure, blood vessel abnormalities, or changes in the ear's ability to conduct sound, as noted in the most recent study 1.

Causes of Pulsatile Tinnitus

The causes of pulsatile tinnitus can be varied, including:

  • High blood pressure
  • Blood vessel abnormalities, such as narrowed arteries or abnormal connections between arteries and veins
  • Increased blood flow due to anemia or hyperthyroidism
  • Changes in the ear's ability to conduct sound

Diagnosis and Treatment

To address this issue, first try lifestyle modifications such as:

  • Reducing salt intake
  • Limiting caffeine and alcohol consumption
  • Managing stress through relaxation techniques If these don't help, consult a healthcare provider as medication for underlying conditions may be necessary, such as antihypertensive medications like amlodipine (5-10mg daily) or lisinopril (10-40mg daily) for high blood pressure, as suggested by previous studies 1.

When to Seek Medical Attention

This symptom warrants medical attention if it's:

  • Persistent
  • Occurs only on one side
  • Accompanied by dizziness, hearing loss, or headaches as it could indicate a more serious condition requiring specific treatment, as highlighted in the guidelines for managing patients with supraventricular arrhythmias 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Possible Causes of Hearing Heartbeat in Ears

  • There are no direct research papers to assist in answering this question, as the provided studies focus on hypertension, anemia, and echocardiography, rather than the specific phenomenon of hearing one's heartbeat in their ears.
  • However, it can be inferred that certain conditions, such as anemia 2 or heart failure 3, may affect the cardiovascular system and potentially lead to unusual sensations or perceptions, including hearing one's heartbeat.
  • Additionally, studies on electrocardiography 4 and echocardiography 5 suggest that cardiovascular health can impact various aspects of cardiac function, which may be related to the sensation of hearing one's heartbeat.

Related Factors

  • Hypertension, as discussed in several studies 2, 4, 5, 6, can have various effects on the cardiovascular system, but its direct relationship to hearing one's heartbeat is unclear.
  • Anemia and iron deficiency, as mentioned in 3, can influence cardiovascular function and may contribute to unusual sensations or perceptions, including hearing one's heartbeat.
  • The provided studies do not offer a clear explanation for the phenomenon of hearing one's heartbeat, particularly in quiet environments like at night.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Prevalence and correlates of anaemia in essential hypertension.

Clinical and experimental pharmacology & physiology, 2008

Research

Recommendations on the Use of Echocardiography in Adult Hypertension: A Report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE).

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2015

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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