Ever run real hard and felt your heartbeat in your ears? Like that but always. It can also happen if you have valve or other heart defects that cause enlargement, but that isn't loud in your ears. It's just so loud in your chest that you can hear it. Sometimes other people can as well.

Pulsatile tinnitus (didn't know this name before but just looked it up), which is when blood pressure is so high that in quiet you hear your own heartbeat and the whooshing of blood in your veins.

I periodically have that, plus regular tinnitus.

PT is the one thing so far that I haven't been able to get fixed with the four different high blood pressure medications that I'm currently on.