Novak Djokovic’s preparation for the US Open has taken a heavy blow after he crashed out of his opening match at the Cincinnati Masters.

Djokovic, who was playing in his first tournament since Wimbledon, struggled with the humid conditions throughout his 2-6, 6-4, 6-4 loss to Thiago Agustín Tirante. He called for a medical timeout during the early stages of the second set and vomited into his towel before having his blood pressure checked. He was able to continue playing but lacked the intensity he had at the start.

“It was not an enjoyable match for me, for sure, the way I felt,” Djokovic said during his press conference. “Not the first, I guess, not the last time, but it is what it is.”

Djokovic entered the match boasting a 19-1 win-loss record at Cincinnati since 2018, with his only loss being to Daniil Medvedev. However, this year was the first time he had played at the event since 2023. The defeat ends his 22-match winning streak against Argentine players on the Tour.

Elaborating about his issue with the conditions, the former world No.1 linked it to a health condition he has had for a while but didn’t specify exactly what it is.

“It’s just the condition that I have health-wise,” he said. “It’s been bothering me for the last couple of years. And a lot of issues, especially when it’s humid and hot.”

“Nerves and everything involved makes it worse,” Djokovic later added.

At the age of 39, Djokovic admits it is possible that he could have played his last match at the Cincinnati Masters. He made his Masters 1000 main draw debut at the tournament in 2005 and has won the title three times.

“I certainly hope so, but it looks more likely not, unfortunately. But let’s see what the future brings.” He said.

It is the second time this year Djoković has lost his opening match at a tournament after the Italian Open, where Dino Prizmic defeated him. He will be defending semi-final points at the US Open, which will get underway on August 30th.