A 24 year old woman who died after collapsing 2 miles from the finish line of the TCS New York Marathon suffered from a rare disease called rhabdomyolysissaid his father.
Steve Apa told the New York Times that his daughter Rachel texted him that she was in pain earlier in the race. His mother was waiting at mile marker 25, he said, but Rachel never made it to the mile mark.
She collapsed at Mile 24. A passerby administered CPR to her, race organizer New York Road Runners said, until the organization’s medical staff took over. A defibrillator was used, the NYRR said, and she was taken by ambulance to a Mount Sinai hospital, where she died after further treatment.
The New York City Office of the Chief Medical Examiner told CBS News that no final determination of the cause of death has been made. NYRR has also not confirmed the cause of his death.
“We are deeply saddened by Rachel’s passing after competing in Sunday’s race,” the organization said in a statement.
Here’s what you need to know about rhabdomyolysis and its connection to strenuous exercise.
What is rhabdomyolysis?
Rhabdomyolysis is a disease that occurs when muscle cells break down and release a protein called myoglobin, along with potassium and other salts, into the bloodstream.
Excess myoglobin can damage the kidneys’ filtration system, while high potassium levels can cause a fatal heartbeat. Up to 50% of people with rhabdomyolysis develop kidney damage.
This disease is very rare: approximately 26,000 people in the United States are diagnosed with it each year, according to the Cleveland Clinic.
Rhabdomyolysis and exercise
Rhabdomyolysis can occur after very strenuous exercise. A person is at higher risk if they exercise in hot weather, are dehydrated or sick.
To prevent exercise-induced rhabdomyolysis, athletes should slowly build up their exercise tolerance, especially after time off. They should also drink enough water, avoid strenuous workouts when sick, and avoid alcohol and stimulants during periods of intense exercise.
Although rhabdomyolysis can be caused by exercise, more and more cases are caused by medications and toxins. Alcohol, cocaine, and heroin are all common triggers. In rare cases, statins can cause rhabdomyolysis, especially when mixed with certain other medications.
Infections like the flu and conditions like heatstroke and seizures can also cause it. Crush injuries can also lead to rhabdomyolysis.
People with sickle cell trait are at higher risk of rhabdomyolysis.
What are the signs of rhabdomyolysis?
The most common signs of rhabdomyolysis are muscle pain, weakness, and dark urine that looks like tea or cola. Some people may also feel feverish, upset stomach, confused, or barely able to urinate.
Symptoms can vary in severity, the Cleveland Clinic said. Symptoms usually develop within one to three days.
A person who develops muscle pain and dark urine after an intense workout should go to the emergency room as soon as possible. Physiologist and anesthetist Dr Michael Joyner told CBS News in 2024 that “rapid treatment can really make a huge difference.”
How is rhabdomyolysis treated?
Treatment for rhabdomyolysis begins with a blood test for the muscle protein creatine kinase. Once the diagnosis is confirmed, doctors will give the patient large amounts of IV fluids, including electrolytes, to flush the myoglobin through the kidneys. Potassium levels are also carefully monitored.
Patients may need additional treatment if their kidneys are damaged. They may need dialysis if their kidneys are failing or their potassium levels remain high. Patients may also receive physical therapy.
The Cleveland Clinic says patients without complications may feel better within a few weeks, but doctors may recommend waiting weeks or even months before returning to exercise.
Gn sports
