Contrast echocardiography utilizing peripheral saline injection was used for the detection of tricuspid regurgitation in 127 patients. In 36 patients prior to contrast echocardiography a tricuspid regurgitation was documented by angiography of the right ventricle. A V-wave synchronous pattern of contrast appearance in the inferior vena cava was detected by subcostal transducer position in 34 patients, and in 27 patients retrograde systolic flow lines across the tricuspid valve were documented by left parasternal transducer position. Correlated with angiographic data, the sensitivity of the method in the detection of a tricuspid regurgitation was 97% and the specificity 100%. False positive findings consisted in A-wave synchronous patterns and in heart-cycle-independent patterns of contrast appearance. Vena caval ultrasonography using size, pulsation, and inspiratory decrease in dimension was not helpful in predicting tricuspid regurgitation. A diameter of the inferior vena cava less than 10 mm/m2 BSA was indicative of normal right ventricular function.