Pulsatile Tinnitus following Aortic Valve replacement.

[Minousdad]

I am making a good recovery following surgery in early March 2024 to replace my Aortic Valve. I am experiencing a constant thumping sound in sync with my heart beat and felt between my ears somewhere in the back of my neck. Anyone might experience this after strenuous exercise as the blood is rushing along the carotid artery. However I experience this all the time including at rest. Background noise during the day helps distract the feeling but if i wake up on the middle of the night it is most disturbing and I have to have the radio on quietly to help me back to sleep.

My valve was a tissue one and thus not necessarily associated with noise. I have spoken with my GP, with a cardiac nurse and with Tinnitus.org. Symptoms are similar to Pulsatile Tinnitus but but there is no agreement as to the cause or treatment. Is it an ENT matter, a cardiac matter or neurological ?

Please reply if you have any theories and especially if you have experienced anything like this.

I have an Echocardiogram booked for next month.

Graham b

[NotanAstronaut]

if you had some left ventricular hypertrophy (thickening) prior to your surgery then the heart still has all that muscle working but against no resistance now, so there is a forceful shockwave going up your carotids with each heart beat. I was told I might get this though haven’t experienced it

In time I think the heart will remodel, loose its excess power and the thumping you feel/hear will lessen. It will take 6months + I would think. Possibly it will be faster if you are on ramipril.

I’m not a cardiologist or a heart surgeon but a retired GP, so I may be wrong!

I would ask to speak to one of these, via their secretary, on the phone or talk to a cardiac nurse at your local hospital if it is limiting your activities or worrying you.

[Minousdad in reply to NotanAstronaut]

Thank you for that reply. I found it most plausible as a possible explanation as to what I am experiencing. It was also encouraging to think that the heart can remodel and that any LV hypertrophy, which undoubtedly must have occurred in all that waiting for surgery, could correct itself.

I am expecting a telephone consultation with my surgeon (or a cardiac nurse) on 15th October so I will be able to discuss my symptoms then.

I should say that I also have some more ‘classic’ tinnitus of the white noise type. There is some research linking LV trouble with tinnitus so I am hoping that both types will improve with time.

Thanks again for your help now and earlier this year.

Minousdad

[NotanAstronaut in reply to Minousdad]

Good stuff. Apologies for the typos in my reply. Did it on my phone and didn’t read through it carefully enough! Let me know what they say if you feel you can. Tinnitus itself can be very hard to stop. I get it intermittently and probably because of too much loud music over the decades. Mine is worse with colds. I’ve been known to hunt round the house late at night for the humming that’s in my head! Fortunately, kinda, my prosthetic valve distracts somewhat from the tinnitus and if that ever stops…. In truth, after a year I don’t notice that too much.

Hope yours settles with time.

[NotanAstronaut]

How is it going?

[Beanlover]

My husband had an aortic valve replacement 5 weeks ago. He is really struggling to sleep because he gets what sounds slightly different to you, but has the same effect. He When he lies flat he is very conscious of his heart beat, but feels breathless. Initially he thought it was related to excess fluid as his ankles /legs are swollen, and he thought fluid came up to heart area when he lay down, but it comes on when he sitting up with his feet down. He worries in the evening as he doesn't know whether he'll get any sleep.Cardiac rehab nurse just said go to GP. GP has doubled his diuretic, but it has had v little effect. He spends a lot of time dozing, and knows he should be moving more, but just feels so tired.Anyone else has similar issues

[Minousdad in reply to Beanlover]

Thank you for posting that message about the noises your husband is experiencing. It is actually only the second I have received as a result of what I originally described. The first one came from a retired GP who gave the explanation that the wall of the heart, specifically the Left Ventricle, had thickened prior to surgery and it needed to ‘remodel’ as I recover. This has proved the most likely explanation of why I hear the thumping in the back of my head. It is nearly a year since my AVR surgery now and I still hear the sound especially when waking during the night but I am less conscious of them than when I posted the comment. My GP, after taking advice from a cardiologist, has dismissed the term ‘Pulsatile Tinnitus, in my case. I am nevertheless hearing my heart beat in sync as the blood rushes through the carotid artery to my head. I can only hope for further improvement.

I do hope your husband will be less bothered by his noises as time goes on. Putting on Radio 4 very quietly during the night has been my solution to sleep problems as this masked or at least provided distraction from the thumping sound. Every case is different and the only comfort I can offer your husband is that patience in recovery brings improvement. Five weeks seems very early in recovery to me now it’s a year since my surgery. I remember I was still wearing my surgical socks for 6 weeks to prevent circulation problems. I still get breathless a year on and feel I need a further Echocardiogram for monitoring what is going on. I wish your husband all the best.