Quantitative and qualitative assessments of echo contrast patterns in the right heart chambers were made in 21 patients with acquired valvular diseases and pulmonary hypertension, as compared to 8 healthy adults. Echo contrast techniques are described in detail. Echo contrast patterns were analysed on records from the tricuspid valve, pulmonary artery and inferior cava-hepatic veins. Quick echo contrast streams of right-ventricular loading and ejection were found to be of shorter duration in patients with pulmonary hypertension, who also showed reflux patterns of echo contrast in inferior cava-hepatic veins. These seem to be sensitive indicators of pulmonary hypertension in patients with acquired valvular disease. Therefore, echo contrast studies of the right heart chambers can be an alternative to intracardiac investigation in these patients.