Marathon: 24-year-old dies after collapse in New York

According to the report, after around 22.5 kilometers, Rachel Apa ran past her mother Michelle Apa, who was watching the race along the route. Steve Apa tracked his daughter from home and wrote her encouraging messages. At just under 29 kilometers, Rachel Apa responded to her father with the word “Ouch,” and after 30.5 kilometers, “Ouch, ouch.”

When Steve Apa received no response to his "final sprint" message after a good 37 kilometers and saw that their tracker was no longer moving, he sent his wife to their last location at kilometer 38.6. She arrived just as the ambulance was pulling away. Rachel Apa was pronounced dead just over six hours later.

Rhabdomyolysis is a disease in which overused muscle tissue breaks down. This causes proteins and electrolytes to enter the blood, which in large quantities can damage organs, put strain on the cardiovascular system and overwhelm the kidneys.

The condition can occur during endurance competitions such as marathons, interval training and other demanding physical activities. Other possible causes include serious injuries, extreme heat, certain medications and previous illnesses.

Typical symptoms include muscle pain, muscle weakness, tenderness and swelling. Nausea, reduced urge to urinate or dark urine can also be a warning sign.

The disease is sometimes difficult to recognize for endurance athletes. Finally, the muscles could also be sore and tired from running. That's why it's important to pay attention to any unusual pain. When preparing for long races, it is also crucial to gradually increase training intensity, recover adequately, drink enough water and not overheat.

Rhabdomyolysis can also affect otherwise healthy athletes. If the disease is not treated promptly, it can be rare and, in severe cases, fatal.

Rachel Apa ran a marathon for the first time. She was part of a “Parkinson’s Champions” team in honor of her late grandfather, who suffered from Parkinson’s. Steve Apa told the New York Times that his daughter played field hockey in college and was "in great health and in great shape."

In the report, a passerby who resuscitated Apa accused the medical staff of not reacting quickly enough. The organization “New York Road Runners” did not respond to a query from the “New York Times” about the behavior of the rescue team.

In a statement, the organization said: "We are deeply saddened by the death of one of our runners after yesterday's race. Our thoughts and sincere condolences go out to the runner’s family, her friends and the entire running community.”