Democrat Eric Armstrong won Iowa’s 20th State House District on Tuesday despite ending his campaign in September because of ongoing health problems, defeating Republican Keith Jones by a substantial margin in a district that had been expected to favor the GOP.

Armstrong received 55.2% of the vote, compared with 44.8% for Jones, according to reported election results. His victory came after he announced on September 7 that he was stepping away from his campaign to focus on his health and recovery. Because his name remained on the November ballot, voters were still able to elect him even though he had stopped actively campaigning.

Armstrong acknowledged that his health challenges remain unresolved but said he intends to fulfill the responsibilities of the office. Speaking to The New York Times after his victory, he said, “I’m going to do my best to represent,” while adding, “But I still have health issues.”

The race was particularly notable because Iowa House District 20, located in Pottawattamie County and including parts of Council Bluffs and Carter Lake, had a Republican-leaning political profile. Armstrong's victory therefore represents a Democratic pickup in a district Republicans had expected to hold.

The seat became open after Democratic state Rep. Josh Turek left the Iowa House to run for the U.S. Senate. Turek also won his race Tuesday, defeating Republican Sen. Ashley Hinson and securing another major victory for Iowa Democrats.

Armstrong's unexpected win adds to a broader Democratic surge across Iowa in the midterm elections, with the party also capturing the governorship and several congressional seats. His victory, however, leaves questions about how he will manage the demands of serving in the legislature while continuing to deal with the health problems that led him to suspend his campaign.