Rachel Apa, a 24-year-old runner who collapsed near mile 24 of the New York City Marathon on November 1, died after being taken to a Mount Sinai hospital. Her father, Steve Apa, said her death was caused by rhabdomyolysis, but the city medical examiner has not issued a final determination.
Apa’s father told CBS News that his daughter had texted him during the race to say she was in pain. Her mother was waiting near mile 25, but Apa collapsed before reaching her.
A bystander began CPR, race organizer New York Road Runners said. Medical staff took over and used a defibrillator before Apa was transported by ambulance to a Mount Sinai hospital, where she died after further treatment. The organization said it was “deeply saddened” by her death.
The New York City Office of the Chief Medical Examiner told CBS News that the cause of death had not been determined. New York Road Runners also did not confirm a cause. The Associated Press reported that Apa collapsed in Central Park.
What rhabdomyolysis can do
Rhabdomyolysis occurs when damaged muscle cells release their contents into the bloodstream. The resulting buildup can injure the kidneys, while elevated potassium can affect the heart’s rhythm. Intense exercise can trigger the condition, although it also has other causes.
Common symptoms include muscle pain, weakness and dark urine. Symptoms can vary, and the report of pain during Apa’s race does not establish the cause of her collapse or death. A person who develops significant muscle pain or dark urine after strenuous exercise should seek urgent medical care.
Reid Bentley 
Nicole French