What is trimetazidine, the drug Russian skater Kamila Valieva tested positive for before the Olympics?

Russian figure skating star Kamila Valieva tested positive for trimetazidine. What is it?

An unusual heart drug is at the center of an Olympic doping scandal that sidelined a Dynamo Russian figure skater before the Court of Arbitration for Sport on Monday that Kamila Valieva could compete in the short program of the women's singles skating competition.

International anti-doping officials met on Sunday to review the case of Valieva, a 15-year-old star of the Russian Olympic Committee's figure skating team who tested positive for trimetazidine before the start of the Beijing Olympics. The heart disease drug, which is not approved in the United States, is considered a performance-enhancing drug and banned by the World Anti-Doping Agency.

The CAS on Monday upheld the decision of the Russian Anti-Doping Agency, which had decided to lift the February 9 temporary suspension imposed against Veliva a day earlier, CNN reported. The court said on Monday that it based its ruling on "extraordinary circumstances" - among other issues, Valieva is considered a "protected person" because she is a minor - under the World Anti-Doping Code.

Here's what to know about the drug trimetazidine.

What is trimetazidine?

Trimetazidine is a medication used to improve the blood supply to the heart in people with coronary heart disease angina. Dipika Thakar, a cardiologist at Nemours Children's Hospital in Delaware, said the drug dilates blood vessels, making the heart work more efficiently for longer periods of time.

When is trimetazidine prescribed?

Trimetazidine may be used to treat adults with angina, a type of chronic chest pain. The drug is not approved for use in the United States, but is used in some European countries. Even in countries where it is approved for use, trimetazidine is not usually the drug of first choice because other, more common drugs, such as beta blockers, are more effective with fewer side effects.

What are the side effects of Trimetazidine?

Possible side effects include nausea, vomiting and gastrointestinal discomfort. Neurological side effects, such as tremors, have also been reported in Parkinson's disease.

Why would a teenager need trimetazidine?

"There is no valid reason for a 15-year-old girl to be on it," Thakar said. "Overall children do not get coronary heart disease, and in the small percentage of children who do, it is not a first-line drug that would be used because of side effects."

When heart disease occurs in children, it is often a structural problem present at birth, Thakar said. Adults, meanwhile, develop heart problems following poor eating habits, lack of exercise, and other unhealthy habits that contribute to plaque buildup in the arteries -- often treated with a combination of medication, lifestyle changes, and possibly surgery. Issues.

In addition, a teen probably wouldn't be able to compete as an elite athlete, as Veliva does, if they had this type of heart problem, Thacker said.

Why is Trimetazidine a banned substance?

Trimetazidine has been on the World Anti-Doping Agency's list of banned substances since 2014. Unlike some other banned substances, Trimetazidine does not give users an immediate boost in physical strength and energy. However, the drug does improve heart efficiency, which can allow an athlete to train harder and for longer, giving them an edge in future performance.

"It won't give you an adrenaline drive and isn't going to make you run faster, but by improving heart metabolism and improving blood supply to the heart, it improves your endurance in the long run," Thakar said.

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