KANSAS CITY -- Jonathan Heasley became queasy as he faced D-backs shortstop Geraldo Perdomo in the top of the fourth inning, and it wasn’t because of nerves or the threat of the Arizona lineup.

Heasley stepped off the mound and vomited in the grass. It wasn’t the first time this happened to him, and it also wasn’t the last time it would happen in Tuesday night’s series opener at Kauffman Stadium.

By the end of Heasley’s outing in the Royals’ 7-3 loss, the right-hander had hurled 4 1/3 scoreless innings -- and hurled three times behind the mound.

“Even in the middle of that, as hard as that is to watch, his response was, ‘This happens,’” manager Mike Matheny said. “It’s not a sick issue. He gets amped up, and that’s something that’s happened to him multiple times, he says, throughout his life. So just got to the point where he looked peaked to me. I know that’s not fun to go through.”

Heasley threw up on the mound in Double-A last year and in the clubhouse before a start with Kansas City this year. When he played high school football in Texas, Heasley said he threw up before every single game.

“Nothing I can do to stop it,” Heasley said. “Just kind of hits me sometimes. It’s a mix of adrenaline and everything, get a little amped up. … I think it’s just the day of … I get super excited, super amped up. Competitive. Unfortunately, it goes straight to my stomach, and sometimes, it comes out.”

So when Heasley stepped off the mound the first time in the top of the fourth, he told Matheny and trainer Kyle Turner that he felt fine. He sipped some water -- brought out to the mound by Daniel Lynch -- and took the ball.

But then it happened again after Heasley walked Perdomo. Still, he felt fine and finished the inning with a flyout.

In the fifth, Heasley got two quick outs, but he threw up for a third time after facing Ketel Marte. That was enough for Matheny to pull Heasley, who was clearly frustrated, and turn things over to the Royals’ bullpen.

“Last year it was one and done,” Heasley said. “And after the fourth inning, I was like, ‘All right, we’re good now.’ And then unfortunately it came back. I wasn’t expecting that. I tried to hold it there and take some deep breaths, but I felt it coming, so I had to step off.

“I was super frustrated. I’ve got 4 2/3 scoreless and feel like I can keep going. But my body said otherwise.”

Heasley was at 79 pitches and, despite battling some erratic fastball command that led to four walks, he had kept the D-backs from scoring by executing his changeup and breaking balls in big moments.

“At some point, we would have had to draw the line,” Matheny said. “The medical team was fine, up until that point, and they checked him out, came back in. And it just got to the point of, ‘Hey, if this happens one more time, we’re going to have to do something.’”

The Royals’ taxed bullpen took over, already down a reliever with lefty Amir Garrett beginning his two-game suspension on Tuesday, and several relievers unavailable because of recent usage.

Jose Cuas gave up the Royals’ one-run lead -- which they got on Bobby Witt Jr.’s Statcast-projected 449-foot solo homer -- in the sixth, but Kansas City quickly lost control from there. Right-hander Josh Staumont, who hadn’t pitched since Thursday, threw a career-high 42 pitches in 1 1/3 innings. He departed in the eighth inning with the bases loaded and was charged with the remaining three runs the D-backs scored off Luke Weaver.

Weaver then needed 46 pitches for 1 2/3 innings to finish the game, yielding two more runs. The pitch count was high enough that closer Scott Barlow was warming with two outs in the ninth in case Weaver couldn’t get through the inning.

“We used every pitcher we had down there, pushed guys,” Matheny said. “Unfortunately, everybody kind of hit a wall.”

Overall, Royals pitchers issued nine walks. The D-backs only struck out four times -- and still left 14 men on base, going 4-for-17 with runners in scoring position.

And with five hits, Kansas City’s offense now has logged six hits or fewer in a franchise-record eight games, the longest streak in the American League since Texas went nine straight last year.

It was a game that left most queasy.