I have some personal experience with heartbeat heard in the ear(s). It is my observation and hypothesis that the heartbeat in the right ear is possibly related to a tricuspid insufficiency and/or pulmonic stenosis and the heartbeat in the left ear is possibly related to a mitral insufficiency and/or aortic stenosis. With your hypertension and mitral prolapse, you are likely having the symptoms as a result of mitral regurgitation. I wonder if you have any feeling of chest pain or upper back pain when you are excited, either in the center or the both sides of the chest and/or upper back. This is an area that we medical professionals have not really paid attention to but simply dismiss it as tinnitus, AV fistula, tumor, and others. Of course, carotid stenosis could also cause similar symptoms.
Your left-sided symptoms sound like a cervical spine (neck) disorder and/or wax-build-up in your ears. Neck strain can cause many head and upper body problems, including muscle pain and twitching, hot and cold sensations, "pins and needles," and noise in the ear--especially during a neck spasm, you might even hear the disk slipping. For more symptoms, you might want to read about Whiplash Syndrome. A doctor or chiropractor can prescribe a soft neck collar as well as special exercises and other therapies. Wear the collar only an hour once a day the first week, or it can cause increased back pain. Afterwards, you might want to use it for several hours, when your neck is under most strain, such as while you're typing or sewing, etc.
If your ear is clogged, even partially, it can cause a pulsing sensation in addition to odd noises. You can clean your ears out to some extent by gently flushing them with warm water. An easy way to do this is to tilt your head during showering and spray the water on the side of your head a couple inches ABOVE your ear, allowing it to flow into the canal indirectly. As soon as you feel your ear is full of water, stop and let it drain out. Repeat this once or twice during each shower for a week. If this doesn't work, you might also try putting a little edible vegetable oil in your ear with a cotton swab or eyedropper. This might dissolve any hardened wax in a few days.
I have THE ANSWER!!! I had the same problem with hearing my pulse in my ear; especially noticeable at night while trying to sleep. ENT doctors were worthless, telling me I'd have to just live with it. A Chiropractor of all people, gave me an adjustment to my neck, and I could hear a lot better in my ear. I went from not being able to tell if someone on the phone was male/female or what they were saying, to knowing exactly who the person was and what they were saying, but the volume was lower in the ear with the sound, after just one adjustment from Dr. Toy in Lawton, OK. (A Logan graduate, so I'd recommend you find another old school Logan grad in your area). After a few more adjustments, the noise finally went away a few months later. Got my hearing tested recently for work, and the left ear was just slightly worse than the right, but I can hear better than most people now. The noise is gone, and all those ENT docs need to go back to school.I had an artery out of place. Easy adjustment. No surgery. People think Chiropractors are quacks, but you need one for this heartbeat in the ear issue.
Isn't "Pulcatile Tinnitus" usually experienced as a 'hissing' sound -- often in the left ear? The results of an echo cardiogram should indicate whether this condition is caused by 'heart murmurs' -- sometimes a mitral valve prolapse -- or not.
Welcome, sorry to hear of your issues. Hearing your heart beat in your ear is not uncommon and does not mean there are any underlying issues. Tinnitus is usually indicated when you have a constant high pitched sound in your ears and is not usually connected to high BP. There is really no way to know if your BP is primary, secondary or idiopathic with no known cause, it can be frustrating.
Jon