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From Rhabdomyolysis To Heart Attack: Why Marathons Can Turn Dangerous

A 24-year-old <span>marathon</span> runner, <span>Rachel Apa</span>, collapsed and died two miles from the finish line at the <span>New York City Marathon</span>. In Hyderabad, 36-year-old IBM software engineer <span>Kommineni Gopi</span> died after suffering a <span><a href="https://www.healthandme.com/health/heart-attack">heart attack</a></span> shortly after completing a marathon.

<a href="https://www.healthandme.com/fitness/24-year-old-marathon-runner-dies-before-finish-line-due-to-muscle-breakdown-what-is-rhabdomyolysis-article-156458470" data-type="tilCustomLink">Apa's death was attributed to rhabdomyolysis</a>, a condition involving severe muscle breakdown, while Gopi died following a heart attack.

According to The New York Times, Apa was a former Division I field hockey player at Bucknell University who had trained for months. Gopi was an experienced amateur runner who had undertaken intensive training and multiple endurance runs.

Although such deaths are rare, the incidents highlight the physical demands of endurance running.

<h2>How Common Are Deaths During Marathons?</h2>

A study published in JAMA, involving 29.3 million US marathon and half-marathon finishers between 2010 and 2023, found:

<ul><li>Cardiac arrest: 0.54 per 100,000 participants (1 in 185,000).</li><li>Cardiac death: 0.20 per 100,000 (1 in 500,000).</li></ul>

Dr Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, said survival has improved with better on-site CPR and defibrillation.

<strong>Also read: </strong><a href="https://www.healthandme.com/fitness/water-or-electrolytes-biggest-hydration-mistakes-first-time-hyrox-athletes-make-article-155181450" data-type="tilCustomLink">Water Or Electrolytes? Biggest Hydration Mistakes First-Time HYROX Athletes Make</a>

According to Dr Sudhir, risk factors include:

<ul><li>Male sex: Cardiac arrest rates are approximately six times higher in men.</li><li>Older age: Risk rises after 40–50 years.</li><li>Underlying heart conditions: Including coronary artery disease, cardiomyopathy and myocarditis.</li><li>Race distance: Full marathons carry higher cardiac arrest risk than half-marathons.</li><li>Environmental stress: Heat, humidity, dehydration and illness.</li></ul>

<h2>Can Extreme Running Affect Heart Health?</h2>

Regular running is associated with lower cardiovascular and all-cause mortality and better blood pressure and glucose control.

However, prolonged extreme endurance training may increase the risk of atrial fibrillation, coronary artery calcification in some athletes and myocardial fibrosis in a small subset. These risks remain low for most runners.

<h2>What Causes Cardiac Arrest During A Marathon?</h2>

<strong>Read More: </strong><a href="https://www.healthandme.com/fitness/lancet-study-1-in-4-adolescents-worldwide-report-no-active-days-every-week-what-are-the-health-risks-article-156465925" data-type="tilCustomLink">Lancet Study: 1 In 4 Adolescents Worldwide Report No Active Days Every Week: What Are The Health Risks?</a>

Causes vary by age. <strong>Younger runners </strong>(below 35–40 years):

<ul><li>Hypertrophic cardiomyopathy</li><li>Arrhythmogenic cardiomyopathy</li><li>Congenital coronary anomalies</li><li>Myocarditis</li><li>Inherited arrhythmias</li></ul>

<strong>Middle-aged and older runners:</strong>

Coronary artery disease is a major cause and can trigger heart attacks or dangerous heart rhythms.

Other causes include heat stroke, severe hyponatremia, aortic dissection, pulmonary embolism and complicated <span>rhabdomyolysis</span>.

<h2>What Is Rhabdomyolysis And Why Is It Dangerous?</h2>

Rhabdomyolysis occurs when damaged muscles release myoglobin and potassium into the bloodstream. Excess potassium can trigger dangerous heart rhythms, while myoglobin can damage the kidneys.

Warning signs include severe muscle pain, weakness and dark urine.

“A marathon is not ‘normal’ exercise. It is EXTREME exercise. While most people don’t develop a problem, deaths occur rarely too,” said Dr Rajeev Jayadevan, former president of IMA Cochin.

“Rhabdomyolysis (muscle breakdown) releases potassium into the bloodstream that causes cardiac arrest. Later events include BP crash and kidney shutdown,” he added on X.

Cardiac arrests often occur in the final quarter of a race, near the finish line or shortly after completion.

<h2>Why Is Marathon Training Important?</h2>

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Attempting a marathon without adequate preparation can be dangerous.

“If you are not a trained runner, don't run. Running without understanding the science of it, running without being fit, running without having a baseline health check, running without proper stamina and endurance are all recipes to disaster,” warned Dr Deepak Krishnamurthy, director and lead cardiologist at KIMS Hospital, on X.

People over 40, those with diabetes or hypertension, smokers and individuals with a family history of premature heart disease should consider cardiovascular evaluation before intensive training.

<h2>How Can Runners Reduce The Risks?</h2>

<ul><li>Increase mileage gradually.</li><li>Avoid running during illness.</li><li>Stay hydrated and include recovery days.</li><li>Avoid excessive NSAID use.</li></ul><strong>On race day:</strong>

<ul><li>Acclimatise to the weather.</li><li>Start at a manageable pace.</li><li>Hydrate according to thirst.</li><li>Stop for chest pain, fainting, unusual breathlessness or palpitations.</li></ul>

<h2>What To Do If A Runner Collapses</h2>

<ul><li>Call emergency services.</li><li>Start CPR if the runner is unresponsive and not breathing normally.</li><li>Use an automated external defibrillator (AED) as soon as possible.</li></ul>

Early CPR and defibrillation can improve survival. 

Marathons offer health benefits, but runners need adequate preparation and should recognise warning signs rather than push through them.

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Heart Attack

Rhabdomyolysis

rhabdo

New York City Marathon

rachel apa

kommineni gopi

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A 24-year-old marathon runner, Rachel Apa, collapsed and died two miles from the finish line at the New York City Marathon. In Hyderabad, 36-year-old IBM software engineer Kommineni Gopi died after suffering a heart attack shortly after completing a marathon.Apa's death was attributed to rhabdomyolysis, a condition involving severe muscle breakdown, while Gopi died following a heart attack.According to The New York Times, Apa was a former Division I field hockey player at Bucknell University who had trained for months. Gopi was an experienced amateur runner who had undertaken intensive training and multiple endurance runs.Although such deaths are rare, the incidents highlight the physical demands of endurance running.How Common Are Deaths During Marathons?A study published in JAMA, involving 29.3 million US marathon and half-marathon finishers between 2010 and 2023, found:Cardiac arrest: 0.54 per 100,000 participants (1 in 185,000).Cardiac death: 0.20 per 100,000 (1 in 500,000).Dr Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, said survival has improved with better on-site CPR and defibrillation.Also read: Water Or Electrolytes? Biggest Hydration Mistakes First-Time HYROX Athletes MakeWho Is At Greater Risk?According to Dr Sudhir, risk factors include:Male sex: Cardiac arrest rates are approximately six times higher in men.Older age: Risk rises after 40–50 years.Underlying heart conditions: Including coronary artery disease, cardiomyopathy and myocarditis.Race distance: Full marathons carry higher cardiac arrest risk than half-marathons.Environmental stress: Heat, humidity, dehydration and illness.Can Extreme Running Affect Heart Health?Regular running is associated with lower cardiovascular and all-cause mortality and better blood pressure and glucose control.However, prolonged extreme endurance training may increase the risk of atrial fibrillation, coronary artery calcification in some athletes and myocardial fibrosis in a small subset. These risks remain low for most runners.What Causes Cardiac Arrest During A Marathon?Read More: Lancet Study: 1 In 4 Adolescents Worldwide Report No Active Days Every Week: What Are The Health Risks?Causes vary by age. Younger runners (below 35–40 years):Hypertrophic cardiomyopathyArrhythmogenic cardiomyopathyCongenital coronary anomaliesMyocarditisInherited arrhythmiasMiddle-aged and older runners:Coronary artery disease is a major cause and can trigger heart attacks or dangerous heart rhythms.Other causes include heat stroke, severe hyponatremia, aortic dissection, pulmonary embolism and complicated rhabdomyolysis.What Is Rhabdomyolysis And Why Is It Dangerous?Rhabdomyolysis occurs when damaged muscles release myoglobin and potassium into the bloodstream. Excess potassium can trigger dangerous heart rhythms, while myoglobin can damage the kidneys.Warning signs include severe muscle pain, weakness and dark urine.“A marathon is not ‘normal’ exercise. It is EXTREME exercise. While most people don’t develop a problem, deaths occur rarely too,” said Dr Rajeev Jayadevan, former president of IMA Cochin.“Rhabdomyolysis (muscle breakdown) releases potassium into the bloodstream that causes cardiac arrest. Later events include BP crash and kidney shutdown,” he added on X.Cardiac arrests often occur in the final quarter of a race, near the finish line or shortly after completion.Why Is Marathon Training Important?      Attempting a marathon without adequate preparation can be dangerous.“If you are not a trained runner, don't run. Running without understanding the science of it, running without being fit, running without having a baseline health check, running without proper stamina and endurance are all recipes to disaster,” warned Dr Deepak Krishnamurthy, director and lead cardiologist at KIMS Hospital, on X.People over 40, those with diabetes or hypertension, smokers and individuals with a family history of premature heart disease should consider cardiovascular evaluation before intensive training.How Can Runners Reduce The Risks?During training:Increase mileage gradually.Avoid running during illness.Stay hydrated and include recovery days.Avoid excessive NSAID use.On race day:Acclimatise to the weather.Start at a manageable pace.Hydrate according to thirst.Stop for chest pain, fainting, unusual breathlessness or palpitations.What To Do If A Runner CollapsesCall emergency services.Start CPR if the runner is unresponsive and not breathing normally.Use an automated external defibrillator (AED) as soon as possible.Early CPR and defibrillation can improve survival. Marathons offer health benefits, but runners need adequate preparation and should recognise warning signs rather than push through them.

from rhabdomyolysis to heart attack: why marathons can turn dangerous

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From Rhabdomyolysis To Heart Attack: Why Marathons Can Turn Dangerous

Delhi Air Pollution: Should You Move Your Morning Walk And Jog Indoors As AQI Nears 400?

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24-Year-Old Marathon Runner Dies Before Finish Line Due To Muscle Breakdown: What Is Rhabdomyolysis?

Health Conditions A-Z

From Rhabdomyolysis To Heart Attack: Why Marathons Can Turn Dangerous

Infant Bleeding Episodes In US Rise As Vitamin K Refusals Double: Why The Shot Matters In Newborns

Delhi Air Pollution: Should You Move Your Morning Walk And Jog Indoors As AQI Nears 400?