Third seed Johanna Konta needed medical help just 10 minutes into her return to action on her way to defeat by Marie Bouzkova at the Lexington Open in Kentucky.
Having held serve in the first game, the British world number 15 halted proceedings two points into the second.
Hunched over her racket, Konta appeared to be breathing heavily and her face was flushed, probably as a consequence of the extreme humidity as well as returning to competitive action after five months.
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After having her blood pressure and pulse checked and consulting the doctor, Konta was able to return to the court.
The 29-year-old has suffered similar issues in the past, notably at the 2016 US Open and at the Fed Cup last year. She recovered to win both matches.
This time she battled on to 3-3 before rising Czech star Bouzkova, 22, secured the first break of the match and took the opening set.
Konta, beaten by the same opponent in her last match before lockdown, secured a break early in the second.
But she immediately dropped serve and a second Bouzkova break secured a 6-4, 6-4 victory.
American Jennifer Brady comfortably beat Britain’s Heather Watson 6-2, 6-1, Tunisia’s Ons Jabeur went 6-2, 6-4 over Catherine Mcnally and sixth seed Magda Linette of Poland defeated American Lauren Davis 6-2, 6-3.
Second seed Aryna Sabalenka downed Madison Brengle of the US 6-1, 7-6, 6-2, while fellow American Jessica Pegula beat Russia’s Vera Zvonareva 6-1, 7-5, 6-4.
At the Prague Open, wildcard Eugenie Bouchard was in impressive form as she swept past eighth seed Veronika Kudermetova.
Bouchard, ranked 330 in the world, won her first match on clay since 2018 with a 6-0, 6-3 victory in just 76 minutes.
The Canadian told the WTA website: “I feel that the first set was tough in almost every game. It’s not like it was a walk in the park.
“I’m proud of myself for battling in every single game. It ended up going my way most of the time.
“I stayed on it every point and didn’t make too many loose errors. I played solid and aggressive, which is what I try to aim for.”
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