BALTIMORE -- After allowing his third career leadoff home run to Cesar Hernandez, John Means tried to shake off his rocky start in Saturday’s 10-4 loss to the Indians at Oriole Park. However, after recording two outs, he gave up a second solo homer to Harold Ramirez over the wall in right-center -- marking the second time in his career he allowed two first-inning home runs.

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One batter later, pitching coach Chris Holt went out to the mound to talk to Means, per the request of manager Brandon Hyde, just to give the left-hander a breather as the inning dragged on. But when Holt arrived, he waved over both Hyde and head athletic trainer Brian Ebel.

The Orioles’ ace exited with left shoulder fatigue -- the same condition that sidelined Means at the start of the 2020 season and caused him to miss his Opening Day assignment. He is scheduled to have an MRI on Sunday to determine next steps.

“When they called me and Brian out there, your heart stops for a second,” said Hyde. “You never want to see a player get hurt, obviously. I felt bad for John. There was a little bit of a lack of finish in his pitches but his velo was good.”

Hyde wants to wait until the results of the MRI before making any decisions for Means. He noted that the injury had been something the hurler has dealt with before, but this was the first time this season that he would undergo testing.

“I felt it more so in warmups when I was out there,” said Means of the fatigue. “The last couple pitches, when I really started to let it eat, I felt it kind of yank. And then every pitch after that, I just felt it at the end of extension.

“This is something [I've] dealt with for years now. I've been trying to attack it this year because I've known that it's nothing serious. It's more annoying than anything.”

In Saturday’s matchup, Means faced only five batters, and the two-thirds of an inning tied the shortest outing of the southpaw's career: Aug. 16, 2020, his first start since coming off the bereavement list.

Cleveland manager Terry Francona spoke to Indians pitching coach Carl Willis before the game, and Willis noticed that Means was shaking his arm during warmups.

“The only thing, Carl had mentioned it, when he was done throwing in the bullpen, he was kind of shaking out his shoulder,” said Francona. “But who knows? We don’t know. We don’t see the kid pitch enough. Is that his mannerisms? We were as surprised as anybody when the pitching coach called the trainer out.”

Means’ average pitch velocity remained consistent, hovering 1 mph faster than his yearly average on all three of his pitches (four-seam fastball, changeup and curveball). His command, however, was lacking. His four-seam fastball, his most-used pitch this season at 51.4 percent, missed the zone 14 out of the 19 times he threw the pitch.

Cedric Mullins, who went 5-for-5 with two homers in the loss, said it’s a scary situation when he watches his ace leave the game so early.

“You know, it’s tough,” said Mullins. “It still looked like his velo was there, so it’s a worrisome situation. I hope he's OK, just hope for the best.”

Hyde noted that having Means on the mound this season has usually meant that the Orioles’ bullpen would get a break. The lefty completed five innings in all but one of his 11 starts this season. 

“He's become so reliable in that way, that I don't want to jinx it,” Hyde said before Saturday’s contest.

Means entered Saturday leading the American League in bWAR (3.2), but he hadn’t looked himself in his three most recent starts prior to Saturday. He allowed two home runs in each of those games, and his season total now sits at 13. Yet even after the pair Means allowed to Cleveland, his ERA is a sterling 2.28 on the season.