Hi, A pulsating sensation during exhalation, especially around the face, could be caused by several different things. The sensation may be related to your respiratory system, your heart, or your nervous system. It could be due to several factors, including anxiety, stress, or a more serious underlying medical condition. Here are a few potential causes of a pulsating sensation during exhalation: * Anxiety or Stress - When you re anxious or stressed, your body can react in several ways, including changes in your breathing pattern, heart rate, and blood pressure. These changes can cause a pulsating sensation in the face or other areas of the body. * Heart Issues - A fluttering sensation in the heart, also known as palpitations, can sometimes be felt in the face, especially around the eyes. If you experienced heart flutters in the past, your heart may be still experiencing irregular beats that are causing the pulsating sensation. * Respiratory Issues - Certain respiratory conditions, such as chronic obstructive pulmonary disease (COPD), can cause changes in your breathing patterns that may lead to a pulsating sensation during exhalation. * Neurological Issues - Some neurological conditions, such as trigeminal neuralgia or multiple sclerosis, can cause facial spasms or twitching that may be felt as a pulsating sensation. If the pulsating sensation continues to be bothersome, it s a good idea to see a healthcare provider for an evaluation. They can help determine the underlying cause of the sensation and recommend appropriate treatment or further testing, if necessary. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician