Hello! Welcome on HCM! I passed carefully through your question and would explain that the pulsating in your head is related to uncontrolled high blood pressure. You should know that your blood pressure values are really high and they can lead to possible hemorrhagic stroke (bleeding in the brain). For this reason, the main thing to do is to lower your blood pressure. That is why it is important discussing with your attending physician on the possibility of making some changes to your actual antihypertensive therapy (if you are actually taking antihypertensive drugs) or start therapy if you don t take any antihypertensive drugs. If the pulsating in your head persists even though your blood pressure values are low, I would recommend performing an angio CT scan of the brain or angio MRI to exclude a possible vascular disorder like a brain aneurysm, which could mimic this clinical scenario. Hope to have been helpful! Wishing all the best, Dr. Iliri