WIMBLEDON, England -- American Madison Keys did not let an ailing opponent or the furnace-like conditions distract her from notching up a 6-7 (4), 7-5, 7-5 victory over Elena-Gabriela Ruse in the first round of Wimbledon on Monday.
"Really tough match," Keys said courtside as she wiped beads of sweat off her face and shoulders. "She played really well, obviously she was suffering a few issues as it was quite toasty out here. My serve got me through that match."
Keys' hopes of extending her perfect 10-0 first-round record at the All England Club appeared to be in jeopardy when her Romanian rival bagged the first set with some sizzling shots from the baseline.
However, despite wrapping ice towels around her neck during the changeovers, the intense heat appeared to get to Ruse in the second set. She called on the trainer, who escorted the Romanian off court for treatment after checking her blood pressure.
With the break lasting close to 10 minutes, Australian Open champion Keys opted to stay in the zone by hitting serves as she waited for her opponent to return to the court.
Trailing 5-3, the scorching 90-degree heat caused Ruse further problems as she collapsed to the ground in agony clutching her right thigh, stricken by a cramp.
Once she was free of pain, the world No. 58 got back on her feet to level the set at 5-5 and stood two games away from toppling the sixth seed.
Keys then reeled off four games in a row to take the second set and surge into a 2-0 lead in the third.
As far as Ruse was concerned, desperate times called for desperate measures. Facing further break points, Ruse whipped across an underarm serve that caught Keys by surprise as it landed on the outer edge of the line.
If the 30-year-old had secured the double break, it might well have been game over for Ruse. Instead, Keys was broken when she served for the match at 5-4, doubling over the net after she raced forward to hit the ball on break point down.
It proved to be Ruse's last hurrah, however. Just two games later, Keys secured victory and next will face Serbia's Olga Danilovic.
No. 4 seed Jasmine Paolini, the 2024 runner-up, came from a set down to beat Latvia's Anastasija Sevastova 2-6, 6-3, 6-2.
The 35-year-old Sevastova, making her first Wimbledon appearance since 2021 after maternity leave and injury, benefitted from Paolini's 13 unforced errors in the first set.
The pair traded breaks twice in the second set but Paolini then seized momentum as Sevastova began to tire.
Sevastova took a medical timeout before the third set, but Paolini rattled off three games in a row to comfortably advance to a second-round meeting with Russia's 80th-ranked Kamilla Rakhimova.
Katie Boulter delighted the home crowd on Centre Court as the Briton battled to knock out No. 9 seed Paula Badosa 6-2, 3-6, 6-4 and reach the second round.
Japan's Naomi Osaka survived a stern test from Australia's Talia Gibson, winning 6-4, 7-6 (4) to reach the second round.
No. 13 Amanda Anisimova and No. 31 Ashlyn Krueger were among the Americans joining Keys in advancing to the second round. Other seeded winners Monday included No. 12 Diana Shnaider, No. 14 Elina Svitolina, No. 21 Beatriz Haddad Maia, No. 22 Donna Vekic, No. 29 Leylah Fernandez and No. 30 Linda Noskova.
Other seeded players to lose in the first round included No. 20 Jelena Ostapenko and American McCartney Kessler (No. 32).
Coco Gauff, coming off her second major title, will play Tuesday on Centre Court against Dayana Yastremska.
Reuters contributed to this report.