Ask the doctor: Should I worry that I can feel a pulse above my ear?

Ask the doctor

Should I worry that I can feel a pulse above my ear?

Published: January, 2006

Q. When I go to bed at night, I feel a pulsing in my head above my left ear. I never feel this when I am sitting or standing. I have high blood pressure and have had three bypasses. Is this something I should be worried about?

A. The artery that passes in front of your ear and then above it is called the temporal artery. For reasons that aren't quite clear, atherosclerosis rarely develops in this artery, so you don't need to worry that it is being clogged up by the same kind of blockage as those that led to your bypass operations.

The temporal artery can develop an inflammation called "temporal arteritis," but this causes a decrease in pulsations. In fact, in temporal arteritis you often can't feel the pulse through this artery at all.

You aren't the only person to feel this. People who have heart disease tend to be more aware of their heartbeats than those who don't have heart trouble. So, especially at night when it is quiet and you push the temporal artery against the pillow, you may be more likely to notice the pulsations even though all is well.

Even so, you should mention this to your doctor. Feeling a pulse through the temporal artery can signal a malformation in the blood vessel, though this is rare. It can also happen when your heart is moving extra blood with each heartbeat, which can occur with common problems like thyroid disease or anemia.

I want to stress that it is extremely unlikely that this is related to your high blood pressure. Contrary to popular belief, high blood pressure doesn't cause any symptoms until the pressure hits an extraordinarily high level. Headaches and nosebleeds, for example, are almost never due to high blood pressure.

High blood pressure is a silent disease — one reason it is a good idea to get your blood pressure checked often.

— Richard Lee, M.D.Associate Editor, Harvard Heart Letter

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