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Pathophysiology of NSTEMI vs STEMI: Pathophysiologically, NSTEMI is somewhat different from STEMI. NSTEMI occurs by developing a complete occlusion of a minor coronary artery or a partial occlusion of a major coronary artery previously affected by atherosclerosis. This causes a partial thickness damage of heart muscle.
The distinction between STEMI and NSTEMI also does not distinguish a transmural from a nontransmural MI. The presence of Q waves or ST-segment elevation is associated with higher early mortality and morbidity; however, the absence of these two findings does not confer better long-term mortality and morbidity.