NYC Marathoner Rachel Apa Dies of Rare Condition Rhabdomyolysis After Race Collapse
A 24-year-old marathoner died after collapsing during the NYC marathon. Learn about rhabdomyolysis, a rare muscle condition linked to intense exercise.
POLICY WIRE — New York, USA — A 24-year-old runner who passed away after collapsing just two miles from the finish line of the TCS New York City Marathon suffered from a rare ailment known as rhabdomyolysis.
Her father, Steve Apa, informed The New York Times that Rachel sent him text messages during the race indicating she was experiencing significant pain. While her mother was waiting for her at Mile 25, Rachel was unable to reach that final milestone.
The fatal collapse occurred at Mile 24, where a bystander began CPR until medical teams from the New York Road Runners arrived. Race medical staff utilized a defibrillator before transporting her by ambulance to a Mount Sinai hospital, where she ultimately died despite receiving further treatment.
The New York Road Runners expressed their grief in a statement, noting their deep sadness over her passing following her participation in Sunday’s event.
Rhabdomyolysis is a medical emergency where muscle cells disintegrate, releasing a protein called myoglobin along with salts and potassium into the bloodstream. High levels of myoglobin can impair the kidneys’ ability to filter, while elevated potassium can lead to fatal heart arrhythmias.
According to the Cleveland Clinic, the condition is rare, with approximately 26,000 annual diagnoses in the United States. Roughly half of those affected by the condition experience kidney injury.
While intense physical exertion can trigger the reaction, risk increases if an athlete is dehydrated, exercising in heat, or suffering from an illness. To mitigate these risks, experts recommend gradually increasing exercise tolerance, maintaining hydration, avoiding hard workouts while sick, and staying away from alcohol and stimulants during peak training.
Beyond exercise, rhabdomyolysis is often triggered by toxins and drugs, including heroin, cocaine, and alcohol. In rare instances, statins may cause it, particularly when combined with other medications. Other causes include the flu, heat stroke, seizures, and crush injuries.
Individuals with the sickle cell trait also face a higher risk for the condition. Common symptoms include muscle weakness, pain, and dark urine resembling cola or tea. Patients may also experience fever, nausea, confusion, or difficulty urinating.
Symptoms typically emerge within one to three days and vary in severity. Diagnosis involves a blood test for creatine kinase; once confirmed, doctors administer aggressive IV fluids and electrolytes to flush myoglobin through the kidneys while monitoring potassium levels.
If kidney failure occurs or potassium remains high, patients may require dialysis or physical therapy. While those without complications may recover in weeks, the Cleveland Clinic suggests athletes might need to wait several months before returning to vigorous exercise.
Reporting by Policy-Wire (PW)>
