Why Would a 15-Year-Old Star Figure Skater Take Heart Medicine?

What does heart medication have to do with figure skating, and what does the Russian figure skater Kamila Valieva have to do with it?
kamila valieva, olympics, beijing 2022, sports, athlete, figure skating, ice skating, russia, doping, scandal, heart medication, trimetazidine
Russian and Olympic officials have suggested heart medication accidentally entered Valieva's system. Some experts are not convinced. Photo: Anne-Christine POUJOULAT / AFP

In another twist in Olympic women’s figure skating, the 15-year-old Russian figure skater Kamila Valieva stumbled on Thursday in what was widely expected to be an ace performance and missed the podium entirely.

Valieva ended in fourth place, after she squandered her significant lead by repeatedly falling and stumbling on ice.

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Her teammates Anna Shcherbakova and Alexandra Trusova claimed first and second respectively. Japan’s Kaori Sakamoto placed third.

Once the gold medal favorite, 15-year-old Kamila Valieva faltered and did not medal. Photo: Kirill KUDRYAVTSEV / AFP

Once the gold medal favorite, 15-year-old Kamila Valieva faltered and did not medal. Photo: Kirill KUDRYAVTSEV / AFP

Valieva had come in first in the short program and emerged as a gold medal favorite earlier this week at the Beijing Winter Games, but an unresolved doping scandal risks eclipsing her dazzling but controversial Olympic debut.

At the center of this storm is her positive test result for a banned heart medication in a sample taken on Dec. 25. The result emerged just days after she landed a historic quadruple jump in the Olympics, an achievement that now comes with an asterisk.

The International Olympic Committee (IOC)’s decision to clear her to compete in the Thursday event has incited global outrage and backlash from the figure skating community. 

“I know absolutely nothing like this has ever happened before, especially from the one that you think is going to be the Olympic gold medalist,” Humberto Contreras, a four-time Mexican figure skating champion, told VICE World News before the Thursday event.

Russian and Olympic officials have suggested that Valieva accidentally ingested the illegal medication trimetazidine. Normally taken to relieve chest pain caused by reduced blood flow to the heart, the drug could have found itself in Valieva’s system from a case of cross-contamination with her grandfather, an IOC executive board member said to reporters.

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But such an explanation seems implausible, medical experts say, given what we know about the medication. 

Though a drug used to treat chest pain, trimetazidine works differently from other medications that relax blood vessels to improve blood flow to the heart. It’s also a metabolic agent that helps break down glucose—a major source of our energy—faster, thus creating a continued supply of energy in conditions where oxygen may be lacking. 

In high-intensity sports, like Olympic figure skating, trimetazidine could help. Vigorous exercise requires a huge amount of oxygen and energy, forcing the heart to beat faster to meet increasing oxygen demand.

The drug helps reduce this need, according to Hamid Merchant, a pharmaceutical scientist from the University of Huddersfield. “Trimetazidine reduces the oxygen demand and helps provide energy to heart muscles even when the oxygen supply is short,” he told VICE World News. 

“This can ultimately increase endurance and reduce fatigue during intense exercises,” Merchant said. 

Past studies have shown trimetazidine improves endurance and sports performance. Athletes who have previously tested positive for this medicine, which has been banned by the regulating body World Anti-Doping Agency since 2014, have been suspended from competing.

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Famously, Chinese swimmer Sun Yang was suspended for three months in 2014 after the heart medication showed up in his drug sample. The 2012 Olympic gold medalist was apparently experiencing chest pains at the time, though Yang is now serving a four-year suspension for refusing to let anti-doping officials take a sample of his blood.  

Russia itself has figured in a similar scandal. It’s now serving a two-year exclusion period following allegations of a state-sponsored doping program in the run-up to the 2014 Sochi Winter Games. This is why Valieva is competing not for Russia technically, but for the Russian Olympic Committee (ROC) formed to allow Russian athletes not involved in the doping scandal to still compete in the Olympics.

Members of the figure skating community were shocked to hear that a panel of arbitrators allowed Valieva to compete despite her positive drug test. 

Contreras, the Mexican figure skater, said Valieva being cleared to compete signaled to other athletes that they could cheat without facing any consequences, a contradiction to the Olympic spirit. 

Lubov Ilyushechkina, a Russian-born Canadian pair skater and two-time bronze medalist on the Grand Prix series, said she admired Valieva’s artistry but the positive test took away from her “unbeatable perfect girl” image.

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“As an athlete, it’s your responsibility to check what is allowed and what is not allowed—not knowing does not release you from responsibility,” she told VICE World News.

“I wish it’s an accident versus [that] it was for systematic and purposeful use, because that will prove that such a quality is impossible without some pharmaceutical additions,” she said.

But in addition to testing positive for trimetazidine, Valieva also took two legal substances used to improve heart function, the New York Times reported this week. Critics say this weakened her argument that the banned drug ended up in her system by accident.

According to a form filled out by the Russian skater, she also took L-carnitine, which helps produce energy, and Hypoxen, a substance that provides energy when the body is oxygen-deprived. 

Merchant, the pharmaceutical scientist, said research hasn’t yet proven that L-carnitine could increase athletic performance. “However, the combination of the three drugs does prompt a red flag,” he said, adding that it could’ve been a deliberate attempt to boost performance. 

Valieva and her entourage have maintained the 15-year-old’s innocence throughout the scandal, without addressing specific questions such as whether the athlete repeatedly took trimetazidine. Her team did not respond to requests for comment from VICE World News. 

The IOC has yet to decide whether the ROC will receive a gold medal in the team event, where Valieva performed her historic quadruple jump. The governing body is also withholding the medal event for the individual women’s competition until a decision is made about her case, which could be weeks or months from now. 

Given she is under 16 and considered a “protected person” under the World Anti-Doping Code, she could receive a lesser punishment than the maximum two-year suspension. Her entourage is also under investigation

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