The Astros knocked Ventura around before he left the game after a visit from the trainer in the third inning. Ventura allowed seven hits and five earned runs in 2⅔ innings.
The Royals later announced that the young right-hander departed with "lateral elbow discomfort," and he will undergo an MRI sometime on Tuesday.
Most ominously, Ventura's velocity dropped to 91 mph against his final batter, which is far below the 98 mph he had averaged coming into Monday.
MLB fans are now well aware what sudden velocity drops and elbow strains can lead to, and seeing Ventura exit the game with Kansas City's trainer didn't leave anyone feeling positive about the situation. Tommy John surgery has shelved numerous high-profile pitchers in 2014, including Miami's Jose Fernandez, and while it is too early to confirm Ventura's injury is that serious, elbow discomfort is never a good sign for a pitcher.
Losing Ventura for any amount of time would be a huge loss for the Royals, as the Dominican Republic native is an early candidate for AL Rookie of the Year. Ventura had posted a 149 ERA+ and 3.36 FIP coming into Monday, while striking out 56 batters and walking just 16 in 54⅔ innings pitched.
The Royals currently sit 5.5 games back of the Tigers in the AL Central, but much of their success has come off the back of a strong pitching staff, which has carried the team's subpar offense. Kansas City had allowed 3.92 runs per game through Sunday, a mark that ranked the Royals ninth among all MLB clubs.
The loss of Ventura would weaken another challenger to Detroit's supremacy in the AL Central, and it is hard to see Kansas City making a serious challenge for first place in the division without its young right-hander.
Ventura has been the second-best starter on the Royals behind the team's top arm, James Shields, and with Jason Vargas and now Danny Duffy slotting into the rotation, Kansas City's staff had found some success and stability in the month of May.
If Ventura does land on the DL, the Royals could turn to someone like Aaron Brooks down in Triple-A to fill his spot. Meanwhile, Bruce Chen is progressing in his rehab from a back injury after throwing live batting practice on Monday. Top prospect Kyle Zimmer would be an intriguing option, but he hasn't yet pitched above Double-A and likely requires a little more seasoning in the minors.