Echocardiograms were obtained simultaneously with the standard indocyanine green injections performed during cardiac catheterization. When injected into cardiac chambers, indocyanine green produced a cloud of echoes that enabled us to visualize characteristic flow patterns in the presence of normal and abnormal cardiac hemodynamics. More than 300 echocardiographic contrast studies have been recorded in patients with various congenital and acquired cardiac defects. The patterns obtained were reproducible, sensitive, and specific.