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Mardy Fish's health concerns creep back with U.S. Open withdrawal

Mardy Fish U.S. Open Mardy Fish withdrew from the U.S. Open prior to his fourth-round match with Roger Federer. (AP)

Roger Federer is into his 34th consecutive Grand Slam quarterfinal, but it's safe to say this isn't how he wanted to get there. Federer advanced at the U.S. Open via a walkover after Mardy Fish withdrew a few hours before their fourth-round match against Federer on Monday.

In a statement, Fish provided little details regarding the illness that forced him out of the tournament, saying only that it was a precautionary measure taken under medical advice. His agent, John Tobias, said Fish will fly home to Los Angeles and get some tests run to get to the root of the problem.

Presumably, the complications stem from the heart ailment that sidelined him in April, requiring a medical procedure to fix an irregular heartbeat. It was a scary time for Fish, who said he had problems sleeping, concerned that something horrible would happen in his sleep. But the diagnosis and treatment helped him understand why his body had been failing him through the first part of the season, where fatigue from a long and successful 2011 season carried over. Most worrisome for Fish, was how to psychologically re-engage in the tennis season. He had to learn to trust his body again, and it sounds like that psychological stress, combined with the understandable pressure to match his 2011 performance, proved overwhelming.

Reporting for CBS, Justin Gimelstob said Fish told him after his tense four-set win over Gilles Simon in the third round on Saturday night that he was suffering both physically and mentally with the stress of the tournament and his concerns over his heart. Fish skipped his post-match press conference obligations, reportedly citing fatigue as well.

Here's what Gimelstob had to say about Fish:

"He's struggling with the stress of trying to reach his potential. This tournament means so much to him. It all just compounded in his withdrawal today.

"Is the physical presupposing the mental or is the mental presupposing the physical? It is symbolic that he's playing one of the biggest matches of his career against the greatest of all time, where expectations should be at an all-time low and he couldn't even take the court. So he's depressed, he's disappointed, he's sad, and he's stressed.

"Pressure is a privilege, and Mardy Fish needs to embrace that."

It has undoubtedly been a pressure-filled year for Fish, who began the year as the top-ranked American, sitting at No. 8 in the world. But with little rest or downtime after competing at the World Tour Finals in London at the end of November, Fish struggled right out the gate, failing to string together back-to-back wins at a tournament until April in Miami, where he made the quarterfinals before losing to Juan Monaco.

Fish kept under wraps that he was dealing with some heart irregularities since as early as April, but after being woken in the middle of the night with an accelerated heart beat, he was rushed to the hospital after his loss in Miami. That incident scared him enough to pull out of the European clay events and investigate his physical issues in earnest. He was eventually diagnosed with a heart arrhythmia and underwent a procedure to fix it. Returning to the tour at Wimbledon, Fish  made the Round of 16 in his first tournament back. He had already decided to skip the Olympics, but still had a solid run through the North American hardcourts, making back-to-back quarterfinals at the Masters events in Toronto and Cincinnati.

Though his ranking has dropped to the very edge of the top 25, Fish looked to have finally built some momentum and put his health scare behind him. That they've crept up again on the eve of a career opportunity must be disappointing for Fish, who worked so hard over the last few years with his fitness in hopes of giving himself these very opportunities late in his career.

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