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History of panic, anxiety disorder. Have cough, sinus issue. Experiencing stabbing pain in ear. Concerned

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Hi, I am a 60 yr old female. High blood pressure well controlled, history of panic and anxiety disorder. About 3 weeks ago I started to be able to hear my heart beat in my right ear. I am at present aging a bit of a cough and sinus issue. I have a slight full feeling in the right ear and every once in a while a short stabbing pain. On occasion the sound will reseed for a few minutes then come back. I flew recently and my ears tend to react negatively to that. But usually within a day they are not plugged feeling and are fine, this is going on and on. If I press below my jaw on the vein the sound recedes but not much. Should I be concerned? I have no history of cardiac issues.
Posted Sun, 12 May 2013 in Ear, Nose and Throat Problems
Answered by Dr. A.K. Srivastava 1 hour later

Thanks for having confidence on H.C.M.

I have tried to uderstand your problem of getting heart beet sound in your ear which may be reduced by pressing below the jaw. You are a hypertensive and also having anxiety. At present you have cough and sinus problem also.

Since your sinus and cough is going on and some times this involves the eustachian tube opening and ultimately tubal blockage develop, which inturn gives feeling of ear blokade and as middle ear goes in negative pressure the sound of adjacent arteries may some time conduct directly to bony labyrinth and patient can hear that sound as in your case. As you said on pressing below the jaw this sound diminishes because the place where you are pressing is the area of CAROTID ARTERY so this artery gets pressed and bood supply to respective area suffers thus you feel it as diminished sound.

To treat it you may take-

(1) Tab Cetrizine.

(2) Steam inhalation.

(3) Tab paracetamol.

This will help you but if even after this your symptoms persist than consultation with your doctor will be necessary for addition of antibiotic.

Above answer was peer-reviewed by
Follow-up: History of panic, anxiety disorder. Have cough, sinus issue. Experiencing stabbing pain in ear. Concerned 15 hours later
So yes, I only have the thumping sound in the one ear and it corresponds with my heart beat. It seemed to begin with a cough and chest congestion. I also have a crackle upon swallowing in that ear. Both ears have the crackle but the right ear is more involved. Does this still sound like the eustacean tube. I am worried it may be a blocked artery as I have read that this also gives the same sound in the ears.As well, the thumping gets louder when I get up and move around.
The sound does not always diminish with pressing below the jaw however
Answered by Dr. A.K. Srivastava 3 hours later
Welcome back,

Crackling sound during swallowing is a normal finding and this indicates opening of eustachian tube. The sound is produced to equalise the pressure of middle ear to external atmosphere. You have louder crackle in blocked ear when there is some fluid in middle ear - now your eustachian tube has returned to work; thus this loudness will resolve in a couple of day.

A blocked artery is unlikely in your case as blocked artery creates ischemia to inner ear thus hair cells gradually dies and they produces humming sound which is continuous called as tinntus. But if you are still not convinced, you may get your checked. A doppler test of carotid and its branches will provide you with enough clues to clear your suspicion.

I hope this clarifies. Let me know if you need more clarifications.

Above answer was peer-reviewed by
Follow-up: History of panic, anxiety disorder. Have cough, sinus issue. Experiencing stabbing pain in ear. Concerned 1 hour later
Why is the sound louder when I get up to a standing position? After laying down for a bit, the sound seems to diminish, but once I get up the pounding is louder and faster. I realize my heart is working harder as I move to a more active position, but that does not account for the loudness
Answered by Dr. A.K. Srivastava 1 hour later
Sound produced externally or from any other sources is distributed equally to both the ears, unless an existing condition in the parts of ear interferes with it. Whenever middle ear is in negative pressure or if there is a fluid within it, the affected ear hears any sound with higher intensity. This in medical terms is known as lateralization of sound.

As you stand or sit, fluid in the ear is spread to the entire medial wall. This transmits any sound directly between ear drum and oval window. Therefore the fluid level changes with standing and lying down posture can explain the changes as described by you.

On the contrary, if this was related to a heart condition, I expect you to hear with both your ears and not on one ear, since blood from the heart reach both ears equally.

To make my points clear, I would suggest you to do the following investigations:

(a) Tympanometery- this will tell you all about your middle ear.

(b) Doppler's study of carotid and its branches- To clarify the vascular abnormality.

You should be convinced as you get the results.

I hope you are satisfied with my explanation. You can revert back if you need more clarifications.

Above answer was peer-reviewed by
Follow-up: History of panic, anxiety disorder. Have cough, sinus issue. Experiencing stabbing pain in ear. Concerned 51 minutes later
I don't understand your reference to the vascular abnormality. Is it inner ear or caratoid artery. Is it XXXXXXX Obviously I will follow up with my GP but would like further explanation.
Answered by Dr. A.K. Srivastava 53 minutes later
Let me clarify.

Doppler study is the gold standard test to rule out vascular abnormality such as blocked arteries. This test will exclude any vascular abnormalities and put your thoughts to rest.
That being said, I am more than convinced that your current symptoms are related to middle ear fluid accumulation / blocked eustachian tube and not a blocked arteries.

I hope this helps. Let me know if you need further clarifications.

Above answer was peer-reviewed by
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