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5] There are two main types of heart attack: non-ST-segment elevation, or NSTEMI, and ST-segment elevation, or STEMI. On the basis of evidence of heart muscle damage and changes in the ST-tracing of the ECG, ACS is classified into three categories: STEMI, NSTEMI, and UA.
NSTEMI refers to non-ST elevation myocardial infarction. That is, parts of the heart muscle is infarcting without any ST elevations on the 12 lead EKG. Usually evidence of a NSTEMI is determined based on serial troponins (a cardiac enzyme). If there is any measurable amount of troponin in the blood, then heart muscle damage, of some sort, has occurred. In the absence of some other cause (PE, for instance, can cause a troponin elevation), NSTEMI is diagnosed.