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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.
Because the ST segment on the ECG does not become elevated in this condition, it is called a non-ST-segment elevation myocardial infarction, or NSTEMI. When the blood clot that forms during ACS completely blocks the artery, all the heart muscle supplied by the artery begins to die.