Objective: To compare heroin users with their age and gender matched relatives as regards non-invasive investigations like chest x-ray, electrocardiography (ECG) and 2D-echocardiography. Study Design: Case control study. Place and Duration of Study: Armed Forces Institute of Cardiology-National Institute of Heart Diseases, Rawalpindi, from Feb 2010 to Jul 2010. Material and Methods: Sixty one heroin users (cases) and their 100 non-substance abuser age and gender matched relatives (controls) were included through non-probability consecutive sampling. Chest x-ray (CXR), 12-lead electrocardiography (ECG) and two-dimensional echocardiography (2D-ECHO) were done of each one and the result was interpreted by respected consultants. The data were analyzed on SPSS version 15. Descriptive statistics of mean and standard deviation (SD) were described for quantitative variables while frequency and percentages for qualitative variables. Independent samples t-test compared quantitative variables ...