A ringing sound like a heartbeat inside the ear is commonly known as vascular pulsatile tinnitus. Some patients can determine whether the patient has vascular pulsatile tinnitus because this sound disappears or diminishes when they press on the large blood vessels in the neck. Vascular pulsatile tinnitus may be caused by the following reasons: 1. Some patients have hemodynamic changes, commonly associated with severe anemia, pernicious hypertension and uncontrolled anemia, which induce hemodynamic changes, and it is easy to develop pulsatile tinnitus. Some patients are overly anxious, poorly rested, depressed, with plant nerve disorders, and overly concerned about their ears. 2. Some patients are caused by vascular malformations in the arteries or veins of the neck, such as carotid aneurysm, jugular vein bulb aneurysm, arteriovenous fistula, arteriovenous malformation, etc. It is recommended to improve the relevant ultrasound and CT examinations for judgment.