The final set of a high-stakes first-round match at the U.S. Open between Japanese star Yoshihito Nishioka and Serbian Miomir Kecmanović was marred by a health scare.

Nishioka suddenly fell to the ground in the fifth set near the baseline. He was in visible pain and remained on the court at the Billie Jean King National Tennis Center for several minutes.

Nishioka appeared to battle serious cramping earlier in the match as temperatures in the New York City borough of Queens climbed into the mid-80s Monday. A heat advisory for the area remains in place for the area through Tuesday night.

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Yoshihito Nishioka plays in the US Open

Yoshihito Nishioka of Japan serves against Miomir Kecmanović of Serbia during a first-round men's singles match at the 2024 U.S. Open at the USTA Billie Jean King National Tennis Center Aug. 26, 2024, in Flushing Meadows. (Matthew Stockman/Getty Images)

Medical personnel and trainers provided Nishioka with water as they treated the 28-year-old. Nishioka eventually required the assistance of a wheelchair to leave the court

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He was forced to retire from the match, which allowed his opponent to advance to the second round of the Grand Slam tournament. Kecmanović will face Italian Lorenzo Musetti in the next round Wednesday.

Yoshihito Nishioka celebrates

Yoshihito Nishioka of Japan celebrates a point against Miomir Kecmanović of Serbia during a first-round men's singles match at the 2024 U.S. Open at the USTA Billie Jean King National Tennis Center Aug. 26, 2024, in the Flushing neighborhood of the Queens borough of New York City.  (Matthew Stockman/Getty Images)

Nishioka later confirmed he experienced cramping in the fourth set of the match before he had multiple spasms.

"Thank you very much for your support…," Nishioka wrote in a post translated from Japanese to English on X. "I was already feeling cramps around 3-3 in the 4th set, and my serve at 5-4 (there) was already cramping. In the final (game), my lower back was more convulsive than my legs, and I couldn’t stand up, and then my legs also convulsed. I was having repeated spasms in my shoulder blades, hips, flanks, and thighs.

Yoshihito Nishioka plays tennis

Yoshihito Nishioka of Japan returns against Miomir Kecmanović of Serbia during their first-round men's singles match at the 2024 U.S. Open at the USTA Billie Jean King National Tennis Center Aug. 26, 2024, in New York City. (Getty Images)

"I started having trouble breathing, but with the help of the team, I was able to get into a wheelchair, and they carried me away despite my convulsions. The convulsions didn’t stop for about an hour, but they’ve subsided now. My body parts are hurting a lot, so I’m planning to skip doubles and go back to Japan."

Nishioka entered the match as the No. 53 player in the world rankings. After dropping the first set to Kecmanović, Nishioka rallied in the second and third sets. Kecmanović bounced back in the fourth set to force a fifth set. 

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Nishioka expressed optimism about his prospects in the Davis Cup, an international team event.

"It’s a shame that it ended so badly and we looked like we could have won the match, but this American (hard-court) season we rose in the rankings and there were many moments that gave us confidence, so we will continue to do our best in the Asian season," Nishioka wrote. "First of all, I’m looking forward to seeing everyone at the Davis Cup."

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