The feasibility of subxiphoid echocardiography to measure the thickness of the right ventricular wall (RVWT) was investigated. In 87 (90.6%) of the 96 patients studied, adequate visualization of the echoes from the right ventricular wall was obtained using the subxiphoid technique. RVWT averaged 0.34 +/- 0.08 cm (mean +/- 1 SD), ranging from 0.2 to 0.5 cm in 25 normal individuals. This was not significantly different from the values in the left ventricular overload group (0.36 +/- 0.10 cm). However, the RVWT was increased significantly (P less than 0.001) in the combined group (0.62 0.18 cm), the right ventricular (RV) pressure overload group (0.60 +/- 0.13 cm) and the RV volume overload group (0.53 +/- 0.11 cm). Thirty-two patients underwent diagnosis right heart catheterization which revealed a good correlation between the RVWT measured echocardiographically and the right ventricular peak systolic pressure (r = 0.84). Subxiphoid echocardiography was considered to be useful in diagnosing right ventricular hypertrophy in adults.