Runner dies after collapsing near finish of New York City Marathon

A 24-year-old woman from Lewisberry, Pennsylvania, collapsed about two miles short of the finish line during the New York City Marathon on Sunday and later died at a hospital, police said. The city medical examiner’s office is still investigating the death. Her father, Steve Apa, told the New York Times that the likely cause was rhabdomyolysis, a condition in which skeletal muscle breaks down rapidly and can lead to kidney damage and heart complications.

When Apa fell, a bystander performed CPR and race staff applied a defibrillator before paramedics transported her to a hospital, but resuscitation efforts were unsuccessful.

"Rhabdo is rare, but I have seen cases at the New York City Marathon before," said Dr. Doug Farrell, a nephrologist at Mount Sinai who was not involved in the case.

Dr. Farrell noted a spike in rhabdomyolysis cases at the 2022 marathon, which he linked to higher heat and humidity. Sunday’s temperatures were milder, in the mid-60s, but heat can still impair the body’s ability to dissipate muscle-generated heat, increasing the risk of muscle breakdown and dehydration.

"When you run, your muscles generate a lot of heat. Your body’s main job is to get rid of it," he explained, adding that core body temperatures can exceed 104 °F in some runners.

Experts said deaths during marathons are rare. Dr. Jonathan Kim, founding director of Emory Sports Cardiology, said sudden cardiac arrest is the most common fatal event in marathons, with myocardial infarction being the leading cause, while rhabdomyolysis-related deaths are "really, really rare."

Kim emphasized that runners should monitor for symptoms such as chest tightness, lightheadedness, shortness of breath, or an unusually rapid heartbeat, and consult a physician before entering a marathon, especially if they have known cardiac risk factors.

Apa, a recent Bucknell University graduate and former Division I field hockey player, was running her first marathon to raise funds for Parkinson’s disease in memory of her grandfather. Her health history and training regimen have not been disclosed.