It’s unclear how much of a factor heat played in the incident, but the temperature in Queens hovered in the mid-80s on Wednesday.
"I was feeling a little bit the conditions," Konta said after the match. "And also, you know, my own energy levels. I was just managing the best that I could with what I had today. Basically my heart rate spiked and I couldn't really control my breathing I started hyperventilating. I started shaking."
After getting up, she walked to her chair and, when the match resumed, promptly double-faulted to give the 71st-ranked Pironkova the set, 7-5.
With the match leveled at a set apiece, Konta was taken to the locker room prior to the start of the decider.
Konta rebounded beautifully in the third set, taking it 6-2. Two hours and 33 minutes after the first ball was struck, she was into the third round in Flushing Meadows.
"I'm feeling a little embarrassed," she said with a smile, "but I'm doing everything that I can to recover well and try to get myself into a state to be ready to compete again on Thursday, Friday. I don't know what day it is."
Next up for Konta is 24th-seeded Belinda Bencic, who defeated Andrea Petkovic in straight sets.