Ask a doctor on the topic of Internal medicine

Pulsating ringing in the ears when moving.

October 30, 2015 | 15,00 EUR | answered by Dr. med. Frauke Gehring

Hello,

Regarding myself: I am male, 27 years old, non-smoker, only drink occasionally, but I am quite overweight because I unfortunately often eat fast food and sweets.

Since yesterday, I have occasionally noticed a high, pulsating noise in my ears during physical activity. It only lasts for a short time and quickly goes away. For example, when I sit on the couch and quickly get up, it happens. It is not constant.

At first, I thought it might be my blood pressure. It is slightly elevated (usually around 130-140 over 90-95), but that is normal for me. It is probably due to my weight and constant tension, as I have an anxiety disorder or I am an extreme hypochondriac who has been to the doctor for all sorts of things.

I also googled it (I know, as a hypochondriac, I shouldn't do that) and quickly found out that a pulsatile tinnitus can have many dangerous causes. Now I am not sure if I should immediately rush to the doctor or if I am exaggerating. I don't even know if I can even call it tinnitus in my case, because when I am sitting normally on the couch and doing nothing, I don't hear anything.

For your information: I have had several EKGs in recent years. Two long-term EKGs in 2010 and 2012. And also various resting EKGs. The last resting EKG was just three months ago. And every time everything was fine, no abnormalities.

However, I think I suffer from extrasystoles, as I often have heart palpitations. This palpitation was usually the reason why I had the EKGs done in the first place, but unfortunately, I never had these problems during the measurements (typical performance effect). According to my description, the doctor said it was probably extrasystoles.

I also had a head CT scan in 2012. Everything was fine there too.

What do you think it could be? Should I get another CT scan to check if I possibly have an AV fistula (or whatever it is called)? Are there any other possible causes? What do you advise me to do?

Dr. med. Frauke Gehring

Good evening,

You can rule out an AV fistula, as you only have this noise occasionally. Especially hypochondriacs should try to have as few examinations as possible, as studies have shown that each examination, even if it goes well, can further promote hypochondria.

Pulsatile tinnitus often arises from tension in the neck and throat area. It might be helpful for you to engage in moderate physical activity. For example, if you also experience back pain, rehabilitation sports could be prescribed for you.

Autogenic training or progressive muscle relaxation according to Jacobson could be very helpful.

I would also recommend a 24-hour blood pressure monitoring. If the pressure, which increases during exertion, is consistently high, you should consider medication. If you improve your lifestyle and the pressure decreases, then medication may no longer be necessary. In the meantime, it's important not to let the pressure damage your veins.

If you are very overweight, your insurance may cover nutritional counseling; you may find things that you enjoy eating... Just distributed a little differently.

Best regards, Dr. Höllering