Updated Sep 20, 2015 at 11:04p ET
A 34-year-old American woman died after collapsing during the Montreal marathon.
Medical officials said the woman had a heart attack midway through the race. Paramedics were unable to revive her and took her to a hospital.
A man in his late 40s collapsed near the finish line after having a heart attack. He was in critical condition at a hospital.
About 20 runners required medical care during the race and 16 were hospitalized.
In the 2011 event, a 32-year-old man died after having a heart attack.
About 35,000 runners from 53 countries ran in the event. Nicholas Berrouard won in 2 hours, 26 minutes, 42 seconds, and Genevieve Asselin Demers topped the women's field.