Runner Rachel Apa, 24, Dies After Collapsing Near Mile 24 of NYC Marathon; Father Cites Rhabdomyolysis

NEW YORK — A 24-year-old woman running her first New York City Marathon has died after collapsing in Central Park about two miles from the finish line. Her father said the cause was rhabdomyolysis, a rare condition in which damaged muscle tissue breaks down and floods the bloodstream.

Rachel Apa, a former college field hockey player from Pennsylvania, collapsed near Mile 24 on Sunday afternoon. She was taken to Mount Sinai Hospital and died there that night.

Her father, Steve Apa, said his daughter was in "perfect health" and had trained for months for the race. He gave the family's account to The New York Times, which first reported her death on Monday.

Final miles

Apa was in New York with her mother, Michelle. Her father followed her progress from their home in Lewisberry, Pennsylvania, through the marathon's tracking app and sent her encouraging texts at each mile.

A video her mother took shows Apa smiling at Mile 14.

Later in the race, her replies became shorter. At Miles 18 and 19 she answered only "Ow" and "Ow ow," and then she stopped responding. Her father said she had kept moving until Mile 24.

At about 1:30 p.m., a spectator nearby saw her collapse in Central Park. Two doctors who were watching the race took turns performing CPR until marathon medical staff arrived with a defibrillator.

Medics took Apa to Mount Sinai Hospital at about 2 p.m. Doctors worked for more than six hours to save her. She was pronounced dead at 9:40 p.m.

Race organizers respond

New York Road Runners, which organizes the marathon, said it was "deeply saddened by the death of one of our runners following yesterday's race." The group told the Times that the last runner to die after a medical incident at the race was in 2024.

So far, everything known about the cause of Apa's death comes from her family. The New York City medical examiner's office had not publicly released findings as of Tuesday morning.

Running for her grandfather

Apa was running with the Parkinson's Champions team to raise money for Parkinson's disease research. She was running in honor of her grandfather, who died of the disease in 2022.

She played Division I field hockey at Bucknell University in Pennsylvania. After college, she worked as a product manager at TE Connectivity, where she oversaw aerospace, defense and commercial relay products.

What is rhabdomyolysis?

Rhabdomyolysis happens when damaged muscle tissue breaks down and releases its contents into the blood faster than the kidneys can remove them.

Those substances include myoglobin, a protein, and potassium, an electrolyte. Myoglobin can damage the kidneys and lead to kidney failure. High potassium levels can disturb the heart's rhythm, which can be life-threatening.

The condition can be caused by trauma, certain medications and infections. It can also be caused by extreme physical exertion, especially in heat or when the body is dehydrated. Early symptoms can include severe muscle pain, weakness and dark urine, although symptoms vary from person to person.

Rhabdomyolysis linked to exercise is rare, but it can affect fit and healthy athletes, not just people who are out of shape. In 2024, five lacrosse players at Tufts University were hospitalized with rhabdomyolysis after a demanding training session.

Long-distance races can bring on the condition. After the 2022 New York City Marathon, when temperatures reached 75 degrees Fahrenheit (24 degrees Celsius) and humidity was close to 80%, 24 runners were treated for rhabdomyolysis.

A record-setting race

Sunday's marathon was the largest ever held. Organizers said 61,146 people finished the race, making it the world's largest marathon for the third year in a row.

The course runs through all five boroughs, starting on Staten Island and ending in Central Park. The final miles, where Apa collapsed, go through the park's rolling hills, a section that can be especially hard for tired runners.

Rare deaths at major races

Deaths at major marathons are rare compared with the number of people who take part. Every large race, however, has medical teams along the course, and many runners are treated each year for dehydration, exhaustion, injuries and other problems.

Medical experts generally tell marathon runners to train gradually, drink enough fluids without overdrinking, adjust their pace for heat and humidity, and stop and get medical help if they feel severe muscle pain, confusion or other warning signs.

Questions remain

Apa's death has led many runners and spectators to ask what warning signs might have been visible during the race. Her short replies to her father in the late miles are now being seen as a possible sign of trouble.

Her family said she had done everything to prepare. She had trained for months and was in excellent physical condition.

Tributes

Friends, former teammates and members of the running community shared tributes online as news of her death spread. Many described her as a dedicated athlete who chose to run her first marathon for a cause tied to her family.

Her family has not announced funeral arrangements.