Rachel Apa, a 24-year-old MBA student, tragically died after collapsing at Mile 24 of the New York City Marathon on Sunday afternoon. Apa was participating in the race to raise money for Parkinson’s disease research, an illness that claimed the life of her grandfather. Her father, Steve Apa, confirmed to the New York Times that rhabdomyolysis, a rare and severe muscle condition, was the cause of her death.
"It’s unfathomable. Perfect health, perfect shape, 24 years old." Steve Apa, Father.
Apa, who was pursuing an MBA at Charleston Southern University, had shared on LinkedIn her personal connection to the cause. "My grandfather was one of my role models growing up. He taught me to stay active, push my limits, and embrace challenges," she wrote, expressing her motivation for running the marathon. Her collapse occurred in Central Park, near 85th Street, around 1:30 p.m.
Steve Apa, monitoring his daughter's progress from his home in Lewisberry, Pennsylvania, via the marathon's tracking app, had been sending her encouraging texts at every mile marker. As the race progressed, her replies grew increasingly terse. At Mile 18, she responded with "Ow," followed by "Ow ow" at Mile 19. By Miles 20, 21, and 22, the app showed her still moving, but no further texts arrived. At Mile 23, her father sent a final message: "Final stretch." Shortly after, the tracking app indicated she had stopped moving.
A spectator, Michaela Nicholas, a hospital social worker, witnessed Apa's collapse near Mile 24. Nicholas, recognizing Rachel's bib number and name, shouted encouragement moments before Apa fell to the ground. Rushing to her side, Nicholas found no pulse. Her fiancée immediately called for medical assistance. Three bystanders, two of whom identified themselves as physicians, initiated CPR. Nicholas held Apa's hand, reassuring her she was not alone. Marathon medical staff quickly arrived, utilizing a defibrillator. Paramedics then transported Apa by ambulance to Mount Sinai Medical Center. Apa's mother, who had been waiting near the finish line, hurried to the hospital. Despite over six hours of intensive efforts by doctors to save her, Rachel Apa was pronounced dead around 9:40 p.m., approximately eight hours after her collapse.
Rhabdomyolysis, often referred to as "rhabdo," is characterized by the rapid breakdown of skeletal muscles. This process releases compounds such as myoglobin and potassium into the bloodstream, which the body is not equipped to process efficiently. These substances can lead to severe complications, including kidney damage, tissue poisoning, and ultimately renal failure. The surge of potassium from damaged muscle cells can also trigger fatal cardiac arrhythmias and cardiac arrest.
The condition can be brought on by various factors, including high-intensity exercise and prolonged workouts, as well as muscle injuries from incidents like car crashes, burns, and electric shocks, and certain medications. Treatment for rhabdomyolysis typically involves intravenous fluids to prevent its progression to severe kidney damage that might necessitate dialysis. According to the Cleveland Clinic, many survivors experience muscle weakness for weeks, and doctors often recommend months of rest from exercise.
The New York Road Runners, the organization behind the marathon, released a statement expressing their sorrow. "We are deeply saddened by the death of one of our runners," the group said. "Our thoughts and sincere sympathies are with the runner’s family, friends, and the entire running community." The organization noted that the last marathon runner to die after a medical incident occurred in 2024.
