Rhabdo linked to NYC marathoner’s death: What to know about the condition
A collapse late in the race
Apa was running her first marathon and had told her father she felt strong. She collapsed near the mile-24 marker at 1:33 p.m. EST, according to The New York Times.
Her father, Steve Apa, said he had repeatedly urged her not to overdo it. After efforts to resuscitate her, she was declared dead at 9:40 p.m. EST.
How rhabdo affects the body
Rhabdomyolysis happens when muscles break down and release their contents into the bloodstream. These include myoglobin, creatine kinase and potassium, according to the Cleveland Clinic. Extreme exercise can trigger the condition, as can physical trauma, heat stroke, some medications, drug abuse or an underlying health condition. The Cleveland Clinic records about 26,000 U.S. cases annually, while Vanderbilt University research indicates about 1,500 deaths a year.
Symptoms and reducing risk
Symptoms vary and may appear within one to three days of muscle breakdown. They can include muscle pain or weakness, dark urine, difficulty urinating, nausea and loss of consciousness; medical attention is advised for these signs.
Experts recommend increasing exercise gradually, staying hydrated until urine is clear, and avoiding hard workouts when sick or in high temperatures. Dr. Bryant Walrod of The Ohio State University Wexner Medical Center said the condition is often seen in endurance sports such as running and cycling.
Key points
- Apa collapsed near mile 24 of her first New York City Marathon and later died.
- Rhabdo involves muscle breakdown that releases substances into the bloodstream.
- The condition can follow extreme exercise, heat, trauma, medications or drug abuse.
- Gradual training, hydration and avoiding intense exercise while sick or in heat may lower risk.