Runner collapses near NYC Marathon finish, later dies; rare muscle disorder cited

A 24-year-old woman collapsed at mile 24 of the TCS New York City Marathon and later died at a Mount Sinai hospital, her father said. He told The New York Times that his daughter, Rachel, had texted him about pain earlier in the race, and that her mother was waiting at mile 25, but Rachel never reached that point.

A bystander performed CPR until medical staff from New York Road Runners (NYRR) took over, and a defibrillator was used before she was transported by ambulance. The New York City Office of the Chief Medical Examiner has not issued a final cause of death, and NYRR has not confirmed a specific cause.

"We are deeply saddened by Rachel's passing following running in Sunday's race," NYRR said in a statement.

Rhabdomyolysis, the condition mentioned by her father, occurs when muscle cells break down and release myoglobin, potassium and other substances into the bloodstream, potentially damaging kidneys and causing heart rhythm disturbances. The Cleveland Clinic estimates about 26,000 diagnoses annually in the United States.

The disorder can be triggered by extreme exertion, especially in hot weather, dehydration, illness, or by substances such as alcohol, cocaine, heroin, and certain medications. Symptoms include muscle pain, weakness, and dark urine; they may appear within one to three days after the trigger.

Medical experts advise immediate emergency care for suspected cases. Dr. Michael Joyner, a physiologist and anesthesiologist, told CBS News that prompt treatment can significantly improve outcomes. Diagnosis involves blood tests for creatine kinase, followed by aggressive intravenous fluid therapy and electrolyte monitoring. Severe cases may require dialysis or additional interventions, and recovery can take weeks to months before resuming intense exercise.