Arteries of the heart blocked by plaque can reduce the flow of blood to the heart possibly resulting in heart attack or death. Plaque is actually fat and cholesterol that accumulates on the inside of the arteries. The arteries of the heart are small and can be blocked by such accumulations. There is a medical procedure that creates more space in the blocked artery by inserting and inflating a tiny balloon into the blood vessel. It is called coronary balloon angioplasty. Angioplasty means “blood vessel repair.” When the balloon is inflated, it compresses the plaque against the wall of the artery, creating more space and improving the flow of blood.

Many doctors choose this technique, because it is less invasive than bypass surgery. Yes, both involve entering the body cavity, but in bypass surgery, the chest must be opened, the ribs must be cut, and the section of diseased artery must be removed and replaced. To replace it, the patient’s body is opened, once again, to acquire a healthy section of artery. Usually, this blood vessel is removed from an artery located in the calf of the leg. This means the patient now has two painful incisions that must heal at the same time. There is far more risk in such bypass surgery than in angioplasty, which involves threading a thin tube, called a catheter, into the circulatory system and working it to the damaged artery.

Angioplasty may take between 30 minutes to 3 hours to complete. It begins with a distinctive dye that is injected into the bloodstream. A thin catheter is then inserted into the femoral artery of the leg, near the groin. The doctor monitors the path of the dye using x-rays. He moves the tube through the heart and into the plaquefilled artery. He inflates the balloon, creating more space, deflates the balloon, and removes the tube. It is important to note that the plaque has not been removed; it has just been compressed against the sides of the artery. Sometimes, a stent may be implanted, a tiny tube of stainless steel that is expandable when necessary. Its function is to keep the artery open.

There is good news and there is bad news. The good news is that the statistics compiled are superb. Ninety percent of all angioplasty procedures are successful. The risk of dying during an operation of this type is less than 2%. The risk of heart attack is also small: 3–5%. Yet heart surgeons do not take any risk lightly; therefore, a team of surgeons stands ready to perform bypass surgery if needed. The length of hospitalization is only three days. The bad news is twofold. First, this procedure treats the condition but does not eradicate the cause. In 20% of the cases, there is a recurrence of plaque. Second, angioplasty is not recommended for all patients. The surgeons must consider the patient’s age, physical history, how severe the blockage is, and, finally, the degree of damage to the artery before they make their determination.

(1) The worst and longest economic crisis in the modern industrial world, the Great Depression in the United States had devastating consequences for American society. At its lowest depth (1932–33), more than 16 million people were unemployed, more than 5,000 banks had closed, and over 85,000 businesses had failed. Millions of Americans lost their jobs, their savings, and even their homes. The homeless built shacks for temporary shelter—these emerging shantytowns were nicknamed Hoovervilles; a bitter homage to President Herbert Hoover, who refused to give government assistance to the jobless. The effects of the Depression—severe unemployment rates and a sharp drop in the production and sales of goods—could also be felt abroad, where many European nations still struggled to recover from World War I.

(2) Although the stock market crash of 1929 marked the onset of the depression, it was not the cause of it: Deep, underlying fissures already existed in the economy of the Roaring Twenties. For example, the tariff and war-debt policies after World War I contributed to the instability of the banking system. American banks made loans to European countries following World War I. However, the United States kept high tariffs on goods imported from other nations. These policies worked against one another. If other countries could not sell goods in the United States, they could not make enough money to pay back their loans or to buy American goods.

(3) And while the United States seemed to be enjoying a prosperous period in the 1920s, the wealth was not evenly distributed. Businesses made gains in productivity, but only one segment of the population—the wealthy—reaped large profits. Workers received only a small share of the wealth they helped produce. At the same time, Americans spent more than they earned. Advertising encouraged Americans to buy cars, radios, and household appliances instead of saving or purchasing only what they could afford. Easy credit policies allowed consumers to borrow money and accumulate debt. Investors also wildly speculated on the stock market, often borrowing money on credit to buy shares of a company. Stocks increased beyond their worth, but investors were willing to pay inflated prices because they believed stocks would continue to rise. This bubble burst in the fall of 1929, when investors lost confidence that stock prices would keep rising. As investors sold off stocks, the market spiraled downward. The stock market crash affected the economy in the same way that a stressful event can affect the human body, lowering its resistance to infection.

(4) The ensuing depression led to the election of President Franklin D. Roosevelt in 1932. Roosevelt introduced relief measures that would revive the economy and bring needed relief to Americans suffering the effects of the depression. In his 100 days in office, Roosevelt and Congress passed major legislation that saved banks from closing and regained public confidence. These measures, called the New Deal, included the Agricultural Adjustment Act, which paid farmers to slow their production in order to stabilize food prices; the Federal Deposit Insurance Corporation, which insured bank deposits if banks failed; and the Securities and Exchange Commission, which regulated the stock market. Although the New Deal offered relief, it did not end the Depression. The economy sagged until the nation entered World War II. However, the New Deal changed the relationship between government and American citizens, by expanding the role of the central government in regulating the economy and creating social assistance programs.

Use the first passage to answer questions 1 through 6 and the second passage to answer questions 7 through 11.