24-Year-Old Runner Rachel Apa Dies of Rhabdomyolysis Near Finish Line at New York City Marathon

Rachel Apa, a 24-year-old from Lewisberry, Pennsylvania, died Sunday after collapsing near the end of the New York City Marathon, with her father saying she suffered from rhabdomyolysis, a rare condition in which extreme muscle breakdown releases substances into the bloodstream that can stop the heart, detikHealth reported.

Apa collapsed in Central Park roughly two miles — about 3.2 to 3.6 kilometers, depending on the account — before the 26.2-mile finish line, according to multiple reports. A bystander performed CPR before race medical staff used a defibrillator and rushed her to Mount Sinai Medical Center, where she was pronounced dead at 9:40 p.m. local time, CNBC Indonesia reported. It was her first marathon.

Final texts to her father: “Ow”

Apa ran with the Parkinson’s Foundation Champions team, raising money in memory of her grandfather, who had Parkinson’s disease. Both of her parents, Steve and Michelle Apa, were at the race to support her.

Michelle Apa recorded her daughter smiling at mile 14, CNBC Indonesia reported. The mood shifted in the messages Rachel sent her father afterward: at around mile 18 she texted “Ow,” and a mile later “Ow, ow,” CNN Indonesia reported. When Steve Apa texted “final stretch” at mile 23, there was no reply.

detikHealth’s account places the messages differently: it reported that Apa texted her father at kilometer 14 around 11:30 a.m., and that by 1:30 p.m. her replies had changed to a single “aw” — an expression of pain — shortly before she went down at mile 24. The outlets agree on the central fact: her final messages signaled pain, followed quickly by collapse.

“Her health was perfect, her physical condition was perfect,” Steve Apa said, according to The Guardian as cited by CNBC Indonesia.

What is rhabdomyolysis, and why is it dangerous?

Rhabdomyolysis — often called rhabdo — occurs when muscle tissue breaks down rapidly and releases its contents, including potassium and the protein myoglobin, into the bloodstream. Dr. Sohaib Imtiaz, chief medical officer at People Inc., told People that the damaged muscle itself is not the main problem; rather, the danger comes from the effects of the muscle breakdown on the body, which can include a dangerous potassium spike that suddenly stops the heart, kidney failure, a drastic drop in blood pressure, or blood-clotting problems.

Dr. Doug Farrell, a nephrologist at Mount Sinai who was not involved in Apa’s care, told CNN Indonesia that rhabdomyolysis is relatively rare but that he has seen similar cases at previous New York City Marathons.

The danger, Imtiaz said, is that the damage can be silent: many people never experience the classic combination of muscle pain, weakness and dark urine, so serious injury develops unnoticed, and a potassium surge may produce no symptoms until it suddenly disrupts the heart’s rhythm. Rhabdo and early heat illness can also cause confusion.

A record field, and a risk that remains small

The 2026 New York City Marathon drew a record 61,146 finishers, Kompas.com reported, part of a global running boom that includes a record 1.3 million registrants for the 2027 London Marathon and tightened qualifying standards at the Boston Marathon.

A 2019 analysis in the BMJ put the death risk at roughly 1 in 150,000 runners, with the risk generally higher among men with undetected coronary artery disease and most incidents occurring in the final quarter of the race. A 2025 study in the Journal of the American Medical Association found that more than 29 million people in the U.S. completed a marathon or half-marathon between 2010 and 2023 — triple the previous decade’s total.

Jack Goodman, professor emeritus of kinesiology at the University of Toronto and a researcher at Sinai Health, told Kompas.com that the rise in reported cases tracks the surge in participation.

New York Road Runners, the race organizer, said the last medical death at the New York City Marathon occurred in 2024.

Official cause of death still under investigation

Steve Apa has said his daughter died of rhabdomyolysis, but the New York City medical examiner’s office is still investigating to confirm the official cause of death, CNN Indonesia reported.

FAQ

• What killed Rachel Apa? The New York City medical examiner’s office has not yet confirmed the official cause.
• In Central Park, about two miles (roughly 3.2–3.6 km) before the finish line of the 42.195-km course, according to reports from CNN Indonesia, CNBC Indonesia and Kompas.com.
• No. CNBC Indonesia reported that the New York City Marathon was her first marathon; she had previously played field hockey in college and worked as a product manager in the tech industry.
• A 2019 BMJ analysis put the risk at about 1 in 150,000 participants, and a 2025 JAMA study counted more than 29 million American marathon and half-marathon finishers from 2010 to 2023.
• CNN Indonesia, citing Mount Sinai nephrologist Dr. Doug Farrell, lists fatigue, weakness, nausea, vomiting and muscle pain — symptoms that can be mistaken for normal exhaustion after hard exercise.

Earlier coverage: 24-Year-Old Runner Dies of Rhabdomyolysis After New York City Marathon

More on this story: 24-Year-Old Runner Dies Near Finish of New York City Marathon

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