import os, json, base64
from io import BytesIO
from pptx import Presentation
from pptx.util import Inches, Pt
from pptx.enum.shapes import MSO_SHAPE
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.dml.color import RGBColor

OUT='/tmp/workspace/cardiomegaly_presentation/output/Cardiomegaly_Talha_Khan_610A.pptx'
ASSET='/tmp/workspace/cardiomegaly_presentation/assets/image_data.json'
prs=Presentation(); prs.slide_width=Inches(13.333); prs.slide_height=Inches(7.5)
blank=prs.slide_layouts[6]
NAVY=RGBColor(12,38,66); BLUE=RGBColor(20,92,150); TEAL=RGBColor(0,151,167); PALE=RGBColor(239,247,250); INK=RGBColor(25,42,58); MUTED=RGBColor(88,105,120); WHITE=RGBColor(255,255,255); RED=RGBColor(190,55,62); GOLD=RGBColor(241,179,54)

def rect(s,x,y,w,h,color, radius=False, line=None):
    sh=s.shapes.add_shape(MSO_SHAPE.ROUNDED_RECTANGLE if radius else MSO_SHAPE.RECTANGLE, Inches(x), Inches(y), Inches(w), Inches(h))
    sh.fill.solid(); sh.fill.fore_color.rgb=color
    sh.line.color.rgb = color if line is None else line
    return sh

def text(s, txt, x,y,w,h, size=20, color=INK, bold=False, align=PP_ALIGN.LEFT, font='Aptos', valign=MSO_ANCHOR.TOP):
    tb=s.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h)); tf=tb.text_frame
    tf.clear(); tf.word_wrap=True; tf.margin_left=Pt(2); tf.margin_right=Pt(2); tf.margin_top=Pt(1); tf.margin_bottom=Pt(1); tf.vertical_anchor=valign
    lines=txt.split('\n')
    for i,line in enumerate(lines):
        p=tf.paragraphs[0] if i==0 else tf.add_paragraph(); p.text=line; p.alignment=align; p.space_after=Pt(5)
        for r in p.runs: r.font.name=font; r.font.size=Pt(size); r.font.bold=bold; r.font.color.rgb=color
    return tb

def bullets(s, items, x,y,w,h, size=19):
    tb=s.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h)); tf=tb.text_frame; tf.clear(); tf.word_wrap=True
    tf.margin_left=Pt(3); tf.margin_right=Pt(2); tf.margin_top=Pt(2); tf.margin_bottom=Pt(2)
    for i,item in enumerate(items):
        p=tf.paragraphs[0] if i==0 else tf.add_paragraph(); p.text=item; p.level=0; p.font.size=Pt(size); p.font.name='Aptos'; p.font.color.rgb=INK; p.space_after=Pt(9); p.bullet=True
    return tb

def footer(s,n):
    rect(s,0,7.18,13.333,.32,NAVY); text(s,'Out Patient Polyclinic Therapy',.45,7.205,4,.18,9,WHITE); text(s,f'{n:02d}',12.25,7.195,.55,.18,10,WHITE,True,PP_ALIGN.RIGHT)

def header(s,title,sub='',n=1):
    rect(s,0,0,13.333,.18,TEAL); text(s,title,.55,.4,12.1,.52,27,NAVY,True)
    if sub: text(s,sub,.57,.93,11.8,.25,11,MUTED)
    rect(s,.55,1.24,1.0,.05,TEAL); footer(s,n)

def add_image(s, stream,x,y,w,h):
    s.shapes.add_picture(stream, Inches(x), Inches(y), width=Inches(w), height=Inches(h))

def diagram_heart(s,x,y,scale=1):
    # stylized heart icon made with circles and triangle
    c1=s.shapes.add_shape(MSO_SHAPE.OVAL,Inches(x),Inches(y),Inches(1.05*scale),Inches(1.05*scale)); c1.fill.solid(); c1.fill.fore_color.rgb=RED; c1.line.color.rgb=RED
    c2=s.shapes.add_shape(MSO_SHAPE.OVAL,Inches(x+.8*scale),Inches(y),Inches(1.05*scale),Inches(1.05*scale)); c2.fill.solid(); c2.fill.fore_color.rgb=RED; c2.line.color.rgb=RED
    tri=s.shapes.add_shape(MSO_SHAPE.ISOSCELES_TRIANGLE,Inches(x+.28*scale),Inches(y+.53*scale),Inches(1.35*scale),Inches(1.35*scale)); tri.rotation=180; tri.fill.solid(); tri.fill.fore_color.rgb=RED; tri.line.color.rgb=RED

def content_slide(title, items, n, sub='', side_label=None):
    s=prs.slides.add_slide(blank); header(s,title,sub,n)
    rect(s,.6,1.55,8.05,5.18,WHITE,True,RGBColor(220,230,236)); bullets(s,items,.92,1.85,7.45,4.7,20)
    rect(s,9.05,1.55,3.65,5.18,PALE,True,RGBColor(215,232,236))
    diagram_heart(s,10.1,2.05,1.25)
    label=side_label or title
    text(s,label,9.42,4.1,2.9,1.25,20,NAVY,True,PP_ALIGN.CENTER,valign=MSO_ANCHOR.MIDDLE)
    return s

with open(ASSET) as f: im=json.load(f)
imgs=[]
for d in im:
    imgs.append(BytesIO(base64.b64decode(d['base64'].split(',',1)[1])))

# 1 title
s=prs.slides.add_slide(blank); rect(s,0,0,13.333,7.5,NAVY); rect(s,0,0,13.333,.22,TEAL); diagram_heart(s,9.5,1.35,1.7)
text(s,'CARDIOMEGALY',.75,1.25,8.4,.75,34,WHITE,True); text(s,'Causes, Types, Clinical Symptoms, ECG and Radiological Changes, Treatment, Beta-Blockers and Cardiac Glycosides',.78,2.12,7.7,1.25,19,RGBColor(215,235,242))
rect(s,.78,4.45,5.8,1.15,BLUE,True); text(s,'Talha Khan\nGroup: 610A',1.05,4.65,3.2,.65,20,WHITE,True); text(s,'Subject: Out Patient Polyclinic Therapy',.8,6.68,6,.25,12,RGBColor(195,218,227))

slides=[
('Definition of Cardiomegaly',['Cardiomegaly means enlargement of the heart or one or more cardiac chambers.','It is a radiological and clinical finding, not a diagnosis by itself.','It may result from pressure overload, volume overload, or primary myocardial disease.','Echocardiography identifies chamber size, valve disease, and ventricular function.'],'What it means'),
('Normal Heart Size',['On a PA chest radiograph, the cardiothoracic ratio (CTR) is used.','CTR = maximum cardiac width divided by maximum internal thoracic width.','A normal adult PA-film CTR is less than 50%.','AP portable films may magnify the heart shadow and give a false impression of enlargement.'],'How to assess'),
('Mechanisms of Enlargement',['Pressure overload: hypertension, aortic stenosis, pulmonary hypertension.','Volume overload: valve regurgitation, shunts, renal fluid overload.','Myocardial disease: dilated cardiomyopathy, myocarditis, ischemic damage.','Pericardial fluid can create pseudo-cardiomegaly.'],'Why it enlarges'),
('Types of Cardiomegaly',['Left ventricular enlargement or hypertrophy.','Right ventricular enlargement or hypertrophy.','Left or right atrial enlargement.','Biventricular or generalized cardiomegaly.','True cardiomegaly versus pseudo-cardiomegaly.'],'Classification'),
('Left Ventricular Hypertrophy',['Common causes: long-standing hypertension and aortic stenosis.','Also occurs in hypertrophic cardiomyopathy and chronic volume overload.','Initially, ejection fraction may be preserved.','Progression can cause diastolic dysfunction, myocardial ischemia, and heart failure.'],'Pressure-loaded LV'),
('Right-Sided Enlargement',['Causes include pulmonary hypertension, COPD, pulmonary embolic disease, and tricuspid valve disease.','Congenital heart disease may cause chronic right-sided volume overload.','May progress to systemic venous congestion and right-sided heart failure.'],'Right heart'),
('Cardiac Causes',['Hypertensive heart disease and ischemic heart disease.','Dilated or hypertrophic cardiomyopathy.','Myocarditis.','Valvular disease: aortic stenosis/regurgitation and mitral disease.','Congenital heart disease and persistent tachyarrhythmia.'],'Common causes'),
('Systemic and Non-Cardiac Causes',['Severe anemia and thyroid disease.','Chronic kidney disease with fluid overload.','Pregnancy-related cardiomyopathy.','Alcohol, cocaine, and cardiotoxic medications.','Hemochromatosis, amyloidosis, acromegaly, and nutritional deficiency.'],'Think beyond heart'),
('Specific Clinical Symptoms',['Exertional dyspnea and reduced exercise tolerance.','Orthopnea and paroxysmal nocturnal dyspnea.','Fatigue, palpitations, chest pain, dizziness, or syncope.','Ankle swelling, rapid weight gain, abdominal distension, and nocturia.'],'Patient presentation'),
('Physical Examination',['Tachycardia or irregular pulse.','Raised jugular venous pressure and peripheral pitting edema.','Displaced diffuse apical impulse; parasternal heave in RV enlargement.','S3 or S4 gallop, cardiac murmurs, basal crackles, hepatomegaly, or ascites.'],'Clinical signs'),
('Red Flags',['Severe breathlessness at rest or acute pulmonary edema.','Cyanosis, chest pain, syncope, marked hypotension.','New rapid atrial fibrillation or marked bradycardia.','Confusion, reduced urine output, or rapidly worsening edema.'],'Urgent referral'),
('Diagnostic Evaluation',['Focused history, examination, blood pressure, and medication review.','ECG and chest radiograph.','Echocardiography is central for structure, ejection fraction, valves, and pericardial fluid.','CBC, renal function, electrolytes, thyroid tests, BNP/NT-proBNP, and troponin when appropriate.'],'Work-up'),
('ECG Changes',['Changes reflect the underlying cause and affected chamber.','LVH or RVH voltage criteria; atrial enlargement and axis deviation.','Bundle branch block, ST-T abnormalities, atrial fibrillation, tachyarrhythmias, or prior infarct Q waves.','Low voltage can occur with pericardial effusion or infiltrative cardiomyopathy.'],'Electrical clues'),
]
for i,(t,items,label) in enumerate(slides,2): content_slide(t,items,i,side_label=label)

# 15 ECG image slide
s=prs.slides.add_slide(blank); header(s,'ECG Features of Left Ventricular Hypertrophy','High voltage and secondary repolarization abnormalities',15)
rect(s,.55,1.5,5.0,5.3,PALE,True); bullets(s,['Tall R waves in V5-V6 and deep S waves in V1-V2.','Increased QRS voltage and possible left-axis deviation.','ST depression and T-wave inversion in lateral leads: LV strain pattern.','Left atrial enlargement can coexist.'],.85,1.85,4.4,4.5,18)
add_image(s,imgs[1],6.0,1.55,6.75,4.65); text(s,'Example ECG: LVH with strain pattern',6.05,6.3,6.55,.3,13,MUTED,False,PP_ALIGN.CENTER)

# 16 chest image
s=prs.slides.add_slide(blank); header(s,'Radiological Changes','Chest radiography supports the diagnosis but does not establish the cause',16)
add_image(s,imgs[0],.58,1.48,6.05,4.9); rect(s,6.95,1.5,5.75,4.9,PALE,True); bullets(s,['Increased CTR on a PA film.','Enlarged ventricular or atrial contours.','Pulmonary venous congestion and upper lobe diversion.','Kerley B lines, interstitial edema, bat-wing edema, or pleural effusions.','Pulmonary artery enlargement in pulmonary hypertension.'],7.28,1.85,5.1,4.35,18); text(s,'Example: enlarged cardiac silhouette with pulmonary congestion',.65,6.45,5.9,.3,12,MUTED,False,PP_ALIGN.CENTER)

# 17-22
more=[
('Role of Echocardiography',['Measures chamber dimensions and ventricular wall thickness.','Assesses left ventricular ejection fraction and regional wall motion.','Identifies valvular stenosis or regurgitation.','Estimates pulmonary pressures and detects intracardiac shunts or pericardial effusion.','It clarifies the cause suggested by X-ray or ECG.'],'Key investigation'),
('General Treatment Principles',['Treat the underlying cause rather than the enlarged cardiac shadow alone.','Control blood pressure and treat ischemic, valvular, thyroid, renal, or arrhythmic disease.','Limit dietary salt when congested; encourage daily weight monitoring.','Use diuretics for fluid overload and refer for cardiology review when structural disease is suspected.'],'Individualize care'),
('HFrEF Drug Treatment',['For suitable patients: ARNI, ACE inhibitor, or ARB.','Evidence-based beta-blocker.','Mineralocorticoid receptor antagonist and SGLT2 inhibitor.','Loop diuretic for congestion.','Selected cases: ivabradine, hydralazine-nitrate, or digoxin.'],'Guideline-directed therapy'),
('Beta-Blockers: Role and Benefits',['Examples: bisoprolol, carvedilol, and metoprolol succinate.','Reduce sympathetic drive, slow heart rate, and reduce arrhythmia risk.','Improve symptoms and survival in stable HFrEF when used appropriately.','Start low and titrate gradually in stable, euvolemic patients.'],'Beta-blockers'),
('Beta-Blockers: Safety Features',['Do not start or rapidly increase dose during acute decompensated heart failure or cardiogenic shock.','Monitor heart rate, blood pressure, congestion, fatigue, and weight.','Use caution with severe bradycardia, high-grade AV block without pacemaker, or active severe bronchospasm.','Avoid abrupt withdrawal unless medically necessary.'],'Safe use'),
('Cardiac Glycosides: Digoxin',['Digoxin inhibits Na+/K+-ATPase, increasing intracellular calcium and contractility.','It increases vagal tone and slows AV nodal conduction.','Consider in selected symptomatic HFrEF despite standard therapy or for rate control in atrial fibrillation.','It may reduce heart-failure admissions but does not clearly improve overall survival.'],'Digoxin'),
('Digoxin: Toxicity and Monitoring',['Possible toxicity: nausea, vomiting, anorexia, confusion, visual disturbance, bradycardia, AV block, and arrhythmias.','Risk increases in renal impairment, hypokalemia, hypomagnesemia, and drug interactions.','Monitor renal function, electrolytes, pulse, symptoms, and serum level when clinically indicated.','Use the lowest effective dose and review medications carefully.'],'Use cautiously'),
('Key Take-Home Messages',['Cardiomegaly is a sign that requires cause-directed evaluation.','Hypertension, ischemic disease, valve disease, and cardiomyopathy are major causes.','ECG and chest X-ray provide clues; echocardiography confirms anatomy and function.','Beta-blockers are essential in stable HFrEF; digoxin has a selective, monitored role.'],'Summary'),
('References',['Fuster and Hurst’s The Heart, 15th ed: Digoxin section.','Goldman-Cecil Medicine: Heart failure and cardiac glycosides.','2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.','Images used for teaching: medical image library examples of cardiomegaly and LVH ECG.'],'Selected sources')]
for idx,(t,items,label) in enumerate(more,17): content_slide(t,items,idx,side_label=label)

prs.save(OUT)
print(OUT, len(prs.slides))