Unlike typical tinnitus, pulsatile tinnitus can sometimes be related to blood moving through vessels near the ear. Changes in blood flow—or simply becoming more aware of that flow—may produce the rhythmic sound. Exercise can temporarily make it more noticeable because the heart pumps faster. Other situations that increase blood flow or alter circulation, including pregnancy, anemia, and an overactive thyroid, may also contribute to the sensation.

There are also blood-vessel conditions that doctors may consider. Narrowing of arteries from atherosclerosis, abnormalities in blood vessels, and, less commonly, aneurysms can sometimes be associated with pulsatile tinnitus. Certain growths near the ear or surrounding blood vessels may also produce similar symptoms. Importantly, hearing a whooshing noise does not mean that you have one of these conditions, and some tumors associated with pulsatile tinnitus are benign.

Because there are many possible explanations, a healthcare professional may ask whether the sound occurs in one or both ears, whether it exactly follows your heartbeat, when it began, and whether anything makes it better or worse. Depending on the findings, an examination, hearing tests, blood tests, or imaging may sometimes be recommended. Identifying the underlying cause can determine whether treatment is necessary.

A brief episode isn’t always a reason for alarm, but new, persistent, or worsening pulsatile tinnitus should be medically assessed, especially when it occurs in only one ear. Seek urgent medical attention if the sound develops suddenly alongside symptoms such as severe headache, dizziness, weakness, vision changes, difficulty speaking, or other neurological symptoms.

The important thing is not to assume the worst—but also not to ignore a persistent heartbeat-like sound.

That unusual whooshing in your ear may simply be harmless, but understanding its cause is the safest way to know.