I'd like to be able to sleep normally

May 24, 2013 3:37 AM

What can cause a fast pulse sensation in the ear that isn't a pulse?

So, I've had this issue becoming more and more regular for some months. I often wake up in the middle of the night (between 2 and 4) with my pulse moderately elevated; sometimes I'm feeling nervous when I wake up. A few times it triggered a panic attack. That's been going on for some years, but more regularly the past year. The worst thing is that I've been chronically a little sleep deprived.

The weirder thing is that the past few months, in my left ear, if I have it against the pillow, I can distinctly feel a very fast (200+ bpm) pulsing sensation. I had my wife put her ear against my throat right under the ear, where it seems to originate from, and she could hear it. I've been feeling my heart for some months, but it appears to be only from early beats, and I just had a stress echocardiogram on Monday in which everything looked good and healthy. Blood pressure is good. The stress test was ordered by my GP after describing things to them and having an ekg that showed a right side glitch they thought might be an enlargement.

I'm asking here because I've got a 10k deductible HSA and I just had to pay 2k for that stress test; this shit is killing me, hopefully only figuratively speaking. I've got an appointment June 17th to talk with a cardiologist and go more thoroughly over the results of the test and bring this up, which I'm sure won't be cheap, either. I'm just wondering in the meantime if anyone has any idea of what could be causing this?
Of course you're not my doctor, unless hi Dr. Lewis!

posted by Red Loop to Health & Fitness (12 answers total)

I'm just wondering in the meantime if anyone has any idea of what could be causing this?

Anxiety.

IANAD, but it sounds like you've just found a new thing to have a panic attack about.
posted by empath at 3:40 AM on May 24, 2013

Do you grind your teeth? I think I have mentioned this on MeFi somewhere before. A while back I would hear this strange loud noise that I almost thought was fluid rushing randomly or some other odd loud noise. I would hear it more when I would try and fall asleep with headphones on. Well, at some point I realized that the sound in my ear was coming from the tension I was creating as I was clenching my jaw. I grind my teeth. I usually wear a little bite guard thing too, but I was clamping down on that and it was creating the sound. I'm not sure if it is exactly the sound you describe, but it seems to be occurring at a similar time in a similar place. Ask your wife if you grind your teeth, or have her look at your jaw as you are falling asleep or asleep and see if you are clenching it. Just a shot in the dark, but I would rather it be that then something cardiovascular I guess.
posted by This_Will_Be_Good at 3:57 AM on May 24, 2013

I've had a "flutter" in my right ear with my head on the pillow for a few years now (it seems to come and go; it's not every night). It sounds similar to the phenomenon you describe, though I have trouble getting to sleep but don't get awoken by it. I've been told it might be tinnitus. Yes, tinnitus, even though it's not ringing, but pulsing. I went to an ear specialist and he did a test, but couldn't recreate the flutter. He looked in my ears with that thing they look in your ears with, shrugged and said "you're ears are fine." I'm not sure this answer is helpful, but I just thought I'd toss out there that it may not be heart/stress related, and may not be "life-threatening." Of course, IANAD, YRMV, etc.
posted by segatakai at 4:13 AM on May 24, 2013

I have acid reflux. I get slight asthma attacks from the reflux. I used to get pretty much what you are experiencing. Before I knew what the problem was, my tight chest and difficulty breathing actually caused panic attacks. I take antacids and I've lifted the head of my bed several inches. Still happens, but not as much.

Edit: if you have acid reflux, your dentist may be able to tell by looking at your back teeth. They'll be smooth and shiny.
posted by tllaya at 4:31 AM on May 24, 2013

The pulsing sounds very much like pulsatile tinnitus.
posted by RustyBrooks at 4:56 AM on May 24, 2013 [1 favorite]

I can remember having a similar sensation a few times, usually coinciding with congestion or a cold. It bore no relationship to my pulse - it was definitely a kind of regular, rapid popping/fluttering thing.

I found that if I was lying on that ear, I could hear it a lot more. Bunching up my pillow to remove any pressure on my outer ear seemed to quiet the sound. The symptoms came and went, and I haven't had them for years now. If I had them again, I'd probably try a decongestant or just change my sleeping position to minimise the effects.

Anxiety can produce an endless array of different physical effects, and it also tends to amplify minor physical symptoms to the point where you think they're certain to be something more ominous. My advice: talk to yourself about how your reaction to this is over the top, and that it's just one little symptom that could be some kind of tinnitus, but almost certainly has nothing to do with your heart.
posted by pipeski at 5:03 AM on May 24, 2013

Response by poster: Not to discount the possible psychological enhancements, I think the fact that my wife could distinctly hear it herself would make it some sort of physiological issue, and one different from tinnitus or teeth grinding; I was awake and had been for a while.
Like I said, my heart should be fine, too; that's why I was wondering what it could be.
posted by Red Loop at 6:22 AM on May 24, 2013

Are you sure that your wife wasn't just hearing your actual pulse? Which was fast because of your anxiety? Just below your ear, she should have been listening approximately over your carotid artery.

The medical term for feeling your heart beat is "palpitations".
posted by treehorn+bunny at 7:21 AM on May 24, 2013

Response by poster: No, the rapid pulsing was definitely different from my normal heart pulse, which I could feel in my wrist going at an only slightly elevated rate, compared to the feeling the feeling below my ear in my throat that my wife heard.
posted by Red Loop at 7:31 AM on May 24, 2013

Guh, I hate the fluttering so much. I have not ever asked the doctor - it's never happening when I'm around one - but it feels as if there are air bubbles or some kind of slow pressure change going on that's making one of my inner-ear mechanisms twitch like that.

It's worse for me when I'm recovering from sinus troubles, but will happen randomly as well (my ears pop from elevation changes several times on my drive to and from work, so they are prone to drama anyway). It can feel distressing, especially if my ears are sore from said sinus trouble, though for me it's not anxiety-attack-level distressing.

In any case, go see an ENT and get it sorted out.
posted by Lyn Never at 8:47 AM on May 24, 2013

Other people can sometimes hear your pulsatile tinnitus, when this is possible it's called "objective pulsatile tinnitus". Tinnitus is usually, but not always, at the same speed as your pulse.
posted by RustyBrooks at 9:53 AM on May 25, 2013

I'm sorry I can't help with how or why, but depending on how fast/slowly this thing can pulse I am pretty sure it's the tensor tympani muscle; this might help with seeking solutions. It wouldn't seem to be a straightforward tensing of the muscle (which is why I'm not entirely sure it's that), as that makes a continuous thrum/flutter noise.

Stress reduction, relaxation, focus training, chronic pain techniques, mindfulness are all things you can look for to get at something tricky like this if no physical, fixable dysfunction is found - what you're looking for is ways to meet your physical reaction and coax it into calming down and not spiralling. Good treatment specialised for panic attacks will be brilliant, fingers crossed.

previously
posted by lokta at 3:10 PM on May 26, 2013