Hearing your heartbeat in your ear is commonly due to a condition called pulsatile tinnitus. This occurs when blood flow changes near the ear or head make the sound of your own pulse audible in one or both ears. It is often caused by blood vessels close to the middle ear transmitting the rhythmic beat of your pulse. Common underlying factors that can cause this phenomenon include:

• High blood pressure, which creates turbulent blood flow in arteries near the ear.
• Atherosclerosis (plaque buildup in arteries), causing narrowed or irregular arteries that alter blood flow.
• Conductive hearing loss, which amplifies internal sounds including blood flow noises.
• Blood vessel abnormalities such as aneurysms, arteriovenous malformations, or malformed vessels near the ear.
• Conditions that increase blood flow, such as exercise, pregnancy, or anemia.
• Certain middle or inner ear problems or bone abnormalities near the ear.

While the sensation of hearing your heartbeat in your ear can be annoying or anxiety-provoking, it is usually not dangerous. However, if the sound persists, worsens, or is accompanied by other symptoms (like headaches, dizziness, or vision changes), it is important to consult a healthcare provider. They may perform a physical exam, listen to blood flow in neck arteries with a stethoscope, and order imaging or hearing tests to identify any underlying causes that need treatment.