Just a few kilometers away from the finish line, tragedy struck.
A remarkable total of 61,146 runners achieved completion in the New York City Marathon on Sunday. However, Rachel Apa, who her father described as being in excellent health, unfortunately, was not among them.
The 24-year-old collapsed close to mile 24, which is approximately 38.6 kilometers into the race that spans 42.2 kilometers. Despite the immediate response from bystanders, paramedics, and doctors at the hospital, she was declared dead later that evening, her heartbroken parents informed the New York Times.
“It’s incomprehensible,” her father, Steve Apa, who was unavailable for comment to CBC News, conveyed to the news outlet.
Each year, an increasing number of individuals seek the opportunity to don their running shoes and challenge themselves with a 42.2-kilometer journey to reach the finish line. Yet, every year, several young and seemingly fit individuals succumb during the attempt—often due to cardiac issues or heart failure.
In total, including Rachel Apa, at least six runners have tragically lost their lives while participating in marathons and half-marathons across the globe in just the last six months. Nevertheless, experts assert that the occurrence rate remains very low, considering that millions participate annually.
Marathons are no more dangerous now than two decades ago, yet their popularity has surged, explained Jack Goodman, a professor emeritus in kinesiology at the University of Toronto and an adjunct scientist in cardiovascular research at the University Health Network in Toronto.
“With a larger population involved, statistically, there will be more incidents, even if they are rare,” Goodman stated to CBC News.
Dr. Christopher Labos, a cardiologist and epidemiologist based in Montreal, remarked to CBC News that any time thousands gather in one place, the likelihood increases that someone might experience a cardiac incident.
“These occurrences gain more media attention because they are shocking when something unexpected arises,” he added.
Rachel Apa is featured in the 2023 field hockey roster on Bucknell University’s athletics website in Lewisburg, Pa. (Bucknellbison.com)
Study Indicates Decreased Mortality Risk
Anyone who has attempted to register for a marathon recently can attest to their growing popularity. A record-breaking 1.3 million individuals have already applied for the 2027 London Marathon. Registration for the Boston Marathon has become so competitive that they have tightened qualifying standards.
In the United States, over 29 million individuals completed marathons and half-marathons from 2010 to 2023, according to a 2025 study published in the Journal of the American Medical Association (JAMA). This figure is three times greater than that of a decade ago, as noted by the researchers.
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On average, the mortality risk stands at about one in 150,000 runners, according to a 2019 global review published in the BMJ medical journal. The risk is generally higher among men, often attributed to coronary artery disease, and fatalities tend to occur in the latter stages of the race, as indicated by the study.
“Though infrequent deaths are widely reported, these might create unwarranted anxiety about potential dangers,” the authors stated.
The 2025 JAMA study highlights that the risk of dying from a cardiac event during long-distance races in the U.S. has decreased by approximately 50% in recent years, likely due to enhanced emergency preparedness, including better access to defibrillators.
However, the study also observed a slight increase in non-fatal cardiac incidents since 2020, which the researchers speculated could stem from limited healthcare access during the COVID-19 pandemic, resulting in fewer identified cases of cardiovascular diseases.
Runners navigate through Queens during the New York City Marathon on Sunday. (Heather Khalifa/The Associated Press)
Expert Insights on Underlying Causes
In most cases of sudden death, there is often an undiagnosed coronary condition that the runner was unaware of, which only surfaces during the race, Goodman noted.
“Sudden cardiac death, regrettably, is frequently the initial indication of heart disease,” he remarked.
Just last month, 24-year-old Treyton Lara collapsed at mile 20 of the Portland Marathon and later died due to a sudden cardiac arrest, as reported by his family. Earlier this year, Julien Autissier, 33, collapsed near the 19-mile mark of the Miami marathon and subsequently died in the hospital, with doctors also suspecting sudden cardiac arrest, according to the Miami New Times.
Roland Liinar, 25, passed away last May after collapsing at the Rimi Riga Marathon in Latvia. That same month, two more runners died after collapsing during half-marathons in both New York and the U.K.
Despite these incidents, from a public health standpoint, the primary concern for most individuals is insufficient physical activity rather than excessive exercise, according to Lagos, a cardiologist and epidemiologist. For young, healthy individuals who have adequately prepared for a marathon, the likelihood of a cardiac incident is “almost certainly negligible.”
Runners cross the finish line in Central Park on Sunday. (Angelina Katsanis/The Associated Press)
‘She Followed All the Guidelines’
Apa, who worked as an industrial-technology product manager, ran to raise funds for Parkinson’s disease in tribute to her grandfather. On her fundraising page, which had accumulated over $26,000 USD by Tuesday evening, she referred to him as her “role model.”
The New York Road Runners, the organization responsible for organizing the New York City Marathon, stated in a news release that CPR was performed on Apa by a bystander and later by medical staff at the event. A defibrillator was also utilized before she was transported to Mount Sinai Hospital, reported The Associated Press.
Formerly a Division I field hockey player at Bucknell University, she was in critical condition upon arrival at the hospital, where medical professionals attempted to save her for several hours without success.
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Steve Apa indicated that Rachel’s death on Sunday was attributed to rhabdomyolysis, a rare but severe condition characterized by the breakdown of muscle cells that enter the bloodstream. Rhabdo, as it is commonly referred to, can be triggered by intense physical exertion.
Instances of exercise-induced rhabdomyolysis are not systematically recorded across Canada, as previously reported by CBC News. However, there has been a recent increase in cases among young women in St. John’s, with health authorities attributing this to rigorous workouts and competitiveness fostered by social media.
Although this was her first marathon, Rachel had been an athlete throughout her life, her father told USA Today, and she had prepared diligently for months.
“She did everything right.”
Rhabdomyolysis is a condition that can happen after an intense workout and can be life-threatening if left untreated.
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