const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

// ─── Color Palette ───────────────────────────────────────────────────────────
const C = {
  navy:   "0A1628",   // dominant dark bg
  deep:   "0D2137",   // slightly lighter dark panels
  teal:   "00B4D8",   // primary accent
  green:  "06D6A0",   // positive/normal
  red:    "EF233C",   // danger/abnormal
  yellow: "FFD166",   // warning/interval labels
  white:  "F8F9FA",
  grey:   "8D99AE",
  lightbg:"112240",   // card backgrounds
};

// ─── Fetch images ─────────────────────────────────────────────────────────────
const imageUrls = {
  normal_ecg:   "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_c630311bd2acdd3957f2db85257d1ef3bbe57e637174feea9c49c44fae267d9c.jpg",
  afib:         "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_3c76fbc6e31a1f92963db97bfbae29eae90022cbdb45c2b5f37af6c14bee4bfc.jpg",
  stemi_ant:    "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_cdfb20f9fc1a8412ffb27a5e6e1ae510547606f1b0c520ad6dc5bda4ec26caeb.jpg",
  stemi_inf:    "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_9a35fdd5019a941abc80f3c820d1706184a69fea96da67e6ce1e6591ad05.jpg",
  av_block:     "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_11ac037ff7836678ddd7fad143600ed71c2a3910d226a34ea257a3618beab0a5.jpg",
  vt:           "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_d0c8263390a11db77a98f37c73e35131257aee921845e98272875e8c3fe8caec.jpg",
  lead_placement:"https://cdn.orris.care/cdss_images/pmc_clinical_VQA_f8756ed1439cae9a8c9451fe1427ae40410bb90ea9442dbc72e08fbf945a3894.jpg",
  lad_stemi:    "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_0f5964997b5f333f6a7b13ecdc70a73ef6e81127eaee03ef38d9c724b26bbf31.jpg",
};

console.log("Fetching images...");
const fetchedImages = {};
for (const [key, url] of Object.entries(imageUrls)) {
  try {
    const result = JSON.parse(execSync(
      `node /home/daytona/skills/shared/scripts/fetch_images.js "${url}"`,
      { timeout: 30000 }
    ).toString());
    if (result[0] && !result[0].error) {
      fetchedImages[key] = result[0].base64;
      console.log(`  ✓ ${key}`);
    } else {
      console.log(`  ✗ ${key}: ${result[0]?.error}`);
    }
  } catch(e) {
    console.log(`  ✗ ${key}: fetch failed`);
  }
}

// ─── Helper: dark slide background ───────────────────────────────────────────
function darkBg(slide) {
  slide.addShape("rect", { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.navy }, line: { type: "none" } });
}

function accentBar(slide, color = C.teal) {
  slide.addShape("rect", { x: 0, y: 0, w: 0.12, h: 7.5, fill: { color }, line: { type: "none" } });
}

function slideTitle(slide, text, color = C.teal) {
  slide.addText(text.toUpperCase(), {
    x: 0.35, y: 0.22, w: 12.5, h: 0.55,
    fontSize: 22, bold: true, color,
    fontFace: "Calibri", charSpacing: 3, margin: 0
  });
  // underline bar
  slide.addShape("rect", { x: 0.35, y: 0.82, w: 12.5, h: 0.04, fill: { color: C.grey }, line: { type: "none" } });
}

function card(slide, x, y, w, h, fillColor = C.lightbg) {
  slide.addShape("roundRect", { x, y, w, h, rectRadius: 0.08, fill: { color: fillColor }, line: { color: C.grey, w: 0.5 } });
}

// ─── Create Presentation ─────────────────────────────────────────────────────
let pres = new pptxgen();
pres.layout = "LAYOUT_WIDE";
pres.title = "ECG – A Complete Guide for Medical Students";

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 1 – Title
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  // large teal diagonal accent
  s.addShape("rect", { x: 0, y: 0, w: 13.3, h: 0.12, fill: { color: C.teal }, line: { type: "none" } });
  s.addShape("rect", { x: 0, y: 7.38, w: 13.3, h: 0.12, fill: { color: C.teal }, line: { type: "none" } });

  // ECG waveform decorative strip
  s.addShape("rect", { x: 0, y: 3.6, w: 13.3, h: 0.8, fill: { color: C.deep }, line: { type: "none" } });

  s.addText("ECG", {
    x: 0.5, y: 0.9, w: 12, h: 2.0,
    fontSize: 96, bold: true, color: C.teal, fontFace: "Calibri",
    align: "center", glow: { size: 8, opacity: 0.4, color: C.teal }
  });
  s.addText("Electrocardiography", {
    x: 0.5, y: 2.7, w: 12, h: 0.9,
    fontSize: 32, bold: false, color: C.white, fontFace: "Calibri", align: "center", charSpacing: 8
  });
  s.addText("A Complete Guide for Medical Students", {
    x: 0.5, y: 4.6, w: 12, h: 0.7,
    fontSize: 20, color: C.grey, fontFace: "Calibri", align: "center", italic: true
  });
  s.addText("Basics  •  Lead System  •  Intervals  •  Rhythm  •  Arrhythmias  •  Ischaemia", {
    x: 0.5, y: 5.5, w: 12, h: 0.55,
    fontSize: 14, color: C.grey, fontFace: "Calibri", align: "center"
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 2 – What is an ECG?
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s);
  slideTitle(s, "What is an ECG?");

  // left text panel
  const points = [
    { text: "Records the electrical activity of the heart from body surface electrodes", bold: false },
    { text: "Each heartbeat generates an electrical impulse detectable by skin electrodes", bold: false },
    { text: "Standard 12-lead ECG provides 12 different 'views' of cardiac electricity", bold: false },
    { text: "Paper speed: 25 mm/sec  |  Standard gain: 10 mm/mV", bold: true },
  ];

  let yPos = 1.05;
  for (const p of points) {
    card(s, 0.35, yPos, 6.0, 0.82, C.lightbg);
    s.addText("▸  " + p.text, {
      x: 0.55, y: yPos + 0.15, w: 5.7, h: 0.55,
      fontSize: 13.5, color: C.white, bold: p.bold, fontFace: "Calibri", wrap: true, margin: 0
    });
    yPos += 0.95;
  }

  // Why we use it box
  card(s, 0.35, 5.0, 6.0, 2.1, "0D1F35");
  s.addText("WHY DO WE USE IT?", { x: 0.55, y: 5.1, w: 5.7, h: 0.4, fontSize: 12, bold: true, color: C.teal, charSpacing: 2, margin: 0 });
  const uses = ["Detect arrhythmias", "Diagnose myocardial infarction", "Assess conduction abnormalities", "Monitor drug effects & electrolytes", "Pre-operative cardiac evaluation"];
  uses.forEach((u, i) => {
    s.addText("• " + u, { x: 0.6, y: 5.55 + i * 0.3, w: 5.5, h: 0.28, fontSize: 12.5, color: C.white, margin: 0 });
  });

  // image right
  if (fetchedImages.normal_ecg) {
    s.addImage({ data: fetchedImages.normal_ecg, x: 6.7, y: 1.0, w: 6.2, h: 6.0 });
    s.addText("Normal 12-Lead ECG — Sinus Rhythm ~64 bpm", {
      x: 6.7, y: 7.05, w: 6.2, h: 0.35,
      fontSize: 10, color: C.grey, italic: true, align: "center", margin: 0
    });
  }
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 3 – Lead Placement
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.green);
  slideTitle(s, "Lead Placement & the 12-Lead System", C.green);

  // Limb leads box
  card(s, 0.35, 1.0, 5.8, 3.0, C.lightbg);
  s.addText("LIMB LEADS (6)", { x: 0.55, y: 1.1, w: 5.4, h: 0.35, fontSize: 13, bold: true, color: C.yellow, charSpacing: 2, margin: 0 });
  const limbLeads = [
    "I   — Right arm (–) → Left arm (+)",
    "II  — Right arm (–) → Left leg (+)",
    "III — Left arm (–) → Left leg (+)",
    "aVR — Right arm (+)  [augmented]",
    "aVL — Left arm (+)   [augmented]",
    "aVF — Left leg (+)   [augmented]",
  ];
  limbLeads.forEach((l, i) => {
    s.addText(l, { x: 0.6, y: 1.52 + i * 0.38, w: 5.4, h: 0.35, fontSize: 12.5, color: C.white, fontFace: "Courier New", margin: 0 });
  });

  // Precordial box
  card(s, 0.35, 4.15, 5.8, 2.95, C.lightbg);
  s.addText("PRECORDIAL LEADS (V1–V6)", { x: 0.55, y: 4.25, w: 5.4, h: 0.35, fontSize: 13, bold: true, color: C.teal, charSpacing: 2, margin: 0 });
  const precLeads = [
    "V1 — 4th ICS, right sternal border",
    "V2 — 4th ICS, left sternal border",
    "V3 — Between V2 and V4",
    "V4 — 5th ICS, midclavicular line",
    "V5 — Anterior axillary line (= V4 level)",
    "V6 — Midaxillary line (= V4 level)",
  ];
  precLeads.forEach((l, i) => {
    s.addText(l, { x: 0.6, y: 4.68 + i * 0.38, w: 5.4, h: 0.35, fontSize: 12.5, color: C.white, fontFace: "Courier New", margin: 0 });
  });

  // image right
  if (fetchedImages.lead_placement) {
    s.addImage({ data: fetchedImages.lead_placement, x: 6.6, y: 1.0, w: 6.3, h: 6.1 });
    s.addText("Precordial lead positions (standard & high V1-V2 for Brugada)", {
      x: 6.6, y: 7.1, w: 6.3, h: 0.3, fontSize: 10, color: C.grey, italic: true, align: "center", margin: 0
    });
  }
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 4 – ECG Paper & Waves
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.yellow);
  slideTitle(s, "ECG Paper, Waveforms & Intervals", C.yellow);

  // Grid info
  card(s, 0.35, 1.0, 6.0, 1.7, C.lightbg);
  s.addText("ECG GRID", { x: 0.55, y: 1.1, w: 5.7, h: 0.35, fontSize: 13, bold: true, color: C.yellow, charSpacing: 2, margin: 0 });
  const grid = [
    "Small box = 1 mm = 0.04 sec (horizontal) = 0.1 mV (vertical)",
    "Large box = 5 mm = 0.20 sec = 0.5 mV",
    "Heart rate = 300 ÷ number of large boxes (R-R)",
  ];
  grid.forEach((g, i) => {
    s.addText("• " + g, { x: 0.6, y: 1.52 + i * 0.38, w: 5.6, h: 0.35, fontSize: 12.5, color: C.white, margin: 0 });
  });

  // Waves table
  const waves = [
    { wave: "P Wave",    duration: "< 0.12 sec",  amplitude: "< 2.5 mm",   meaning: "Atrial depolarization",         color: C.green },
    { wave: "PR Interval", duration: "0.12–0.20 sec", amplitude: "—",      meaning: "AV conduction time",            color: C.teal },
    { wave: "QRS Complex", duration: "< 0.12 sec", amplitude: "Variable",  meaning: "Ventricular depolarization",    color: C.yellow },
    { wave: "ST Segment",  duration: "Variable",   amplitude: "Isoelectric ±1mm", meaning: "Ventricular plateau",   color: C.white },
    { wave: "T Wave",      duration: "0.10–0.25 sec", amplitude: "< 10 mm", meaning: "Ventricular repolarization",  color: C.teal },
    { wave: "QT Interval", duration: "< 0.44 sec (QTc)", amplitude: "—",   meaning: "Total ventricular activity",  color: C.yellow },
    { wave: "U Wave",      duration: "Variable",   amplitude: "< 1 mm",    meaning: "Purkinje repolarization (sometimes)", color: C.grey },
  ];

  // Header
  card(s, 0.35, 2.85, 12.6, 0.42, "0D2137");
  ["Waveform", "Duration", "Amplitude", "Meaning"].forEach((h, i) => {
    const xs = [0.45, 2.85, 5.15, 7.3];
    const ws = [2.3, 2.2, 2.1, 5.5];
    s.addText(h, { x: xs[i], y: 2.9, w: ws[i], h: 0.3, fontSize: 12, bold: true, color: C.teal, margin: 0 });
  });

  waves.forEach((w, i) => {
    const yy = 3.32 + i * 0.53;
    const bg = i % 2 === 0 ? C.lightbg : C.deep;
    card(s, 0.35, yy, 12.6, 0.5, bg);
    s.addText(w.wave,      { x: 0.45, y: yy + 0.1, w: 2.3, h: 0.3, fontSize: 12.5, bold: true,  color: w.color, margin: 0 });
    s.addText(w.duration,  { x: 2.85, y: yy + 0.1, w: 2.2, h: 0.3, fontSize: 12,   color: C.white,  margin: 0 });
    s.addText(w.amplitude, { x: 5.15, y: yy + 0.1, w: 2.1, h: 0.3, fontSize: 12,   color: C.white,  margin: 0 });
    s.addText(w.meaning,   { x: 7.3,  y: yy + 0.1, w: 5.5, h: 0.3, fontSize: 12,   color: C.grey,   margin: 0 });
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 5 – Systematic Interpretation
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.teal);
  slideTitle(s, "Systematic ECG Interpretation — 8-Step Method");

  const steps = [
    { num: "1", title: "Rate",         desc: "300 ÷ large boxes between R waves  |  Regular: count boxes; Irregular: 6-second strip × 10", color: C.teal },
    { num: "2", title: "Rhythm",       desc: "Regular or irregular?  Is every P followed by a QRS?",                                        color: C.green },
    { num: "3", title: "P Waves",      desc: "Present? Upright in I, II, aVF?  One before each QRS?  Morphology?",                         color: C.yellow },
    { num: "4", title: "PR Interval",  desc: "0.12–0.20 sec  |  Prolonged → AV block  |  Short → pre-excitation (WPW)",                    color: C.teal },
    { num: "5", title: "QRS Width",    desc: "Narrow (<0.12 sec) = supraventricular  |  Wide (≥0.12 sec) = BBB or ventricular",            color: C.yellow },
    { num: "6", title: "QRS Axis",     desc: "Normal: –30° to +90°  |  LAD: <–30°  |  RAD: >+90°  |  Use leads I and aVF",                color: C.green },
    { num: "7", title: "ST / T Waves", desc: "Elevation or depression?  T wave changes? — ischaemia, strain, electrolytes",                color: C.red },
    { num: "8", title: "QT Interval",  desc: "Corrected QTc (Bazett formula) normal < 440 ms  |  Long QT → risk of torsades",              color: C.teal },
  ];

  const cols = 2, rows = 4;
  const w = 6.25, h = 1.38, xStart = 0.35, yStart = 1.05, gap = 0.12;
  steps.forEach((st, i) => {
    const col = i % cols, row = Math.floor(i / cols);
    const x = xStart + col * (w + gap);
    const y = yStart + row * (h + gap);
    card(s, x, y, w, h, C.lightbg);
    // number circle
    s.addShape("ellipse", { x: x + 0.12, y: y + 0.35, w: 0.52, h: 0.52, fill: { color: st.color }, line: { type: "none" } });
    s.addText(st.num, { x: x + 0.12, y: y + 0.35, w: 0.52, h: 0.52, fontSize: 14, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0 });
    s.addText(st.title, { x: x + 0.75, y: y + 0.12, w: w - 0.85, h: 0.42, fontSize: 14.5, bold: true, color: st.color, margin: 0 });
    s.addText(st.desc,  { x: x + 0.75, y: y + 0.55, w: w - 0.85, h: 0.75, fontSize: 11.5, color: C.white, wrap: true, margin: 0 });
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 6 – Normal Sinus Rhythm
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.green);
  slideTitle(s, "Normal Sinus Rhythm (NSR)", C.green);

  const criteria = [
    "Rate:          60–100 bpm",
    "Rhythm:        Regular (R-R intervals equal)",
    "P Wave:        Upright in I, II, aVF  |  Inverted in aVR",
    "PR Interval:   0.12–0.20 sec  (constant)",
    "QRS:           Narrow < 0.12 sec",
    "ST Segment:    Isoelectric (at baseline)",
    "T Wave:        Upright in I, II, V3–V6",
  ];
  criteria.forEach((c, i) => {
    const yy = 1.1 + i * 0.55;
    card(s, 0.35, yy, 5.7, 0.48, C.lightbg);
    s.addText(c, { x: 0.55, y: yy + 0.09, w: 5.4, h: 0.3, fontSize: 13, color: C.white, fontFace: "Courier New", margin: 0 });
  });

  if (fetchedImages.normal_ecg) {
    s.addImage({ data: fetchedImages.normal_ecg, x: 6.35, y: 1.0, w: 6.6, h: 5.5 });
    s.addText("NSR — 12-lead ECG demonstrating normal sinus rhythm at ~64 bpm", {
      x: 6.35, y: 6.55, w: 6.6, h: 0.35, fontSize: 10, color: C.grey, italic: true, align: "center", margin: 0
    });
  }

  card(s, 0.35, 5.1, 5.7, 2.0, "0D2137");
  s.addText("KEY CLINICAL POINT", { x: 0.55, y: 5.2, w: 5.4, h: 0.35, fontSize: 12, bold: true, color: C.green, charSpacing: 2, margin: 0 });
  s.addText("NSR indicates the SA node is the dominant pacemaker. Any deviation from these criteria constitutes an abnormality requiring further evaluation.", {
    x: 0.55, y: 5.6, w: 5.4, h: 1.35, fontSize: 12.5, color: C.white, wrap: true, margin: 0
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 7 – Atrial Fibrillation
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.red);
  slideTitle(s, "Atrial Fibrillation (AF)", C.red);

  const afPoints = [
    { label: "Rate",      val: "Atrial: 350–600 bpm  |  Ventricular: variable 60–180 bpm" },
    { label: "Rhythm",    val: "IRREGULARLY IRREGULAR — hallmark feature" },
    { label: "P Waves",   val: "Absent — replaced by fibrillatory (f) waves; chaotic baseline" },
    { label: "PR Interval", val: "Unmeasurable (no organised P wave)" },
    { label: "QRS",       val: "Usually narrow; may be wide if aberrant conduction" },
    { label: "Causes",    val: "HTN, mitral valve disease, thyrotoxicosis, alcohol, ischaemia" },
    { label: "Risk",      val: "Stroke risk — assess with CHA₂DS₂-VASc score" },
  ];

  afPoints.forEach((p, i) => {
    const yy = 1.05 + i * 0.56;
    card(s, 0.35, yy, 6.1, 0.5, C.lightbg);
    s.addText(p.label + ":", { x: 0.5, y: yy + 0.1, w: 1.4, h: 0.3, fontSize: 12, bold: true, color: C.teal, margin: 0 });
    s.addText(p.val, { x: 1.95, y: yy + 0.1, w: 4.4, h: 0.3, fontSize: 12.5, color: p.label === "Rhythm" ? C.red : C.white, bold: p.label === "Rhythm", margin: 0 });
  });

  if (fetchedImages.afib) {
    s.addImage({ data: fetchedImages.afib, x: 6.75, y: 1.0, w: 6.2, h: 6.0 });
    s.addText("AF — irregularly irregular rhythm, absent P waves, fibrillatory baseline", {
      x: 6.75, y: 7.05, w: 6.2, h: 0.35, fontSize: 10, color: C.grey, italic: true, align: "center", margin: 0
    });
  }
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 8 – AV Blocks
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.yellow);
  slideTitle(s, "AV Conduction Blocks", C.yellow);

  const blocks = [
    {
      name: "1st Degree",
      color: C.green,
      features: ["PR interval > 0.20 sec (>5 small boxes)", "Every P wave conducts to ventricles", "All QRS complexes present", "Usually benign — no treatment required"],
    },
    {
      name: "2nd Degree — Mobitz I (Wenckebach)",
      color: C.yellow,
      features: ["Progressive PR lengthening", "Eventually a QRS is DROPPED", "P:QRS ratio e.g. 3:2, 4:3", "Due to AV node disease (often reversible)"],
    },
    {
      name: "2nd Degree — Mobitz II",
      color: C.red,
      features: ["Constant PR interval", "Sudden non-conducted P wave (QRS dropped)", "Infranodal conduction disease", "Risk of progression → complete block"],
    },
    {
      name: "3rd Degree (Complete Heart Block)",
      color: C.red,
      features: ["Complete AV dissociation", "P waves and QRS at different rates", "Escape rhythm: junctional 40–60 bpm or ventricular 20–40 bpm", "EMERGENCY — pacemaker required"],
    },
  ];

  const bw = 6.25, bh = 2.6, gap2 = 0.15;
  blocks.forEach((b, i) => {
    const col = i % 2, row = Math.floor(i / 2);
    const x = 0.35 + col * (bw + gap2);
    const y = 1.05 + row * (bh + gap2);
    card(s, x, y, bw, bh, C.lightbg);
    // top colour bar
    s.addShape("rect", { x, y, w: bw, h: 0.38, fill: { color: b.color }, line: { type: "none" } });
    s.addText(b.name, { x: x + 0.15, y: y + 0.04, w: bw - 0.2, h: 0.3, fontSize: 13, bold: true, color: C.navy, margin: 0 });
    b.features.forEach((f, j) => {
      s.addText("• " + f, { x: x + 0.2, y: y + 0.5 + j * 0.5, w: bw - 0.35, h: 0.45, fontSize: 12, color: C.white, wrap: true, margin: 0 });
    });
  });

  if (fetchedImages.av_block) {
    // overlay a small chart below – but cards fill the space. Show image on right if room is tight
    // adjust layout: show AV block comparison image at bottom strip
    s.addImage({ data: fetchedImages.av_block, x: 0.35, y: 6.3, w: 12.6, h: 1.05 });
    s.addText("Comparison chart: 1st, 2nd, and 3rd degree AV blocks", {
      x: 0.35, y: 7.35, w: 12.6, h: 0.12, fontSize: 9, color: C.grey, italic: true, align: "center", margin: 0
    });
  }
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 9 – Ventricular Tachycardia
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.red);
  slideTitle(s, "Ventricular Tachycardia (VT) & Ventricular Fibrillation (VF)", C.red);

  const vtFeats = [
    ["Rate",       "VT: 100–250 bpm  |  VF: 300–500 bpm (chaotic)"],
    ["QRS",        "WIDE (≥0.12 sec)  |  Monomorphic or polymorphic"],
    ["P Waves",    "AV dissociation — P waves march through at slower rate"],
    ["Fusion beats","Capture beats and fusion beats confirm VT diagnosis"],
    ["Morphology", "LBBB or RBBB pattern depending on origin"],
    ["Causes",     "CAD, cardiomyopathy, electrolyte disturbance, drugs"],
    ["Management", "Unstable → DC cardioversion  |  Stable → amiodarone/lidocaine"],
    ["VF",         "No organised QRS — chaotic waveform  |  DEATH without defibrillation"],
  ];

  vtFeats.forEach((f, i) => {
    const yy = 1.05 + i * 0.56;
    card(s, 0.35, yy, 5.9, 0.5, i === 7 ? "2D0A0E" : C.lightbg);
    s.addText(f[0] + ":", { x: 0.5, y: yy + 0.1, w: 1.4, h: 0.3, fontSize: 12, bold: true, color: C.teal, margin: 0 });
    s.addText(f[1], { x: 1.95, y: yy + 0.1, w: 4.2, h: 0.3, fontSize: 12.5, color: i === 7 ? C.red : C.white, bold: i === 7, margin: 0, wrap: true });
  });

  if (fetchedImages.vt) {
    s.addImage({ data: fetchedImages.vt, x: 6.55, y: 1.0, w: 6.4, h: 5.8 });
    s.addText("Monomorphic VT — wide QRS complexes, AV dissociation, capture beat visible", {
      x: 6.55, y: 6.85, w: 6.4, h: 0.35, fontSize: 10, color: C.grey, italic: true, align: "center", margin: 0
    });
  }
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 10 – STEMI
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.red);
  slideTitle(s, "ST-Elevation Myocardial Infarction (STEMI)", C.red);

  // Criteria box
  card(s, 0.35, 1.0, 5.8, 1.9, C.lightbg);
  s.addText("DIAGNOSTIC CRITERIA FOR STEMI", { x: 0.55, y: 1.1, w: 5.5, h: 0.35, fontSize: 12, bold: true, color: C.red, charSpacing: 1, margin: 0 });
  s.addText("• ≥2 contiguous leads with ST elevation:\n  – ≥1 mm in limb leads\n  – ≥2 mm in V1–V3 (men), ≥1.5 mm (women)\n  – Or new LBBB + ischaemic symptoms", {
    x: 0.55, y: 1.52, w: 5.5, h: 1.3, fontSize: 12.5, color: C.white, wrap: true, margin: 0
  });

  // Lead territories table
  const territories = [
    { leads: "V1–V4",       wall: "Anterior",          artery: "LAD",         color: C.teal },
    { leads: "I, aVL, V5–V6", wall: "Lateral",         artery: "LCx / LAD",  color: C.green },
    { leads: "II, III, aVF",  wall: "Inferior",        artery: "RCA (85%)",  color: C.yellow },
    { leads: "V7–V9 (posterior)",wall: "Posterior",    artery: "RCA / LCx",  color: C.teal },
    { leads: "aVR ↑ + diffuse↓", wall: "LMCA / Proximal LAD", artery: "LMCA",color: C.red },
  ];

  card(s, 0.35, 3.05, 5.8, 0.38, "0D2137");
  ["Leads", "Wall", "Artery"].forEach((h, i) => {
    const xs2 = [0.45, 2.15, 3.95];
    const ws2 = [1.6, 1.7, 1.9];
    s.addText(h, { x: xs2[i], y: 3.1, w: ws2[i], h: 0.28, fontSize: 12, bold: true, color: C.teal, margin: 0 });
  });
  territories.forEach((t, i) => {
    const yy = 3.48 + i * 0.56;
    card(s, 0.35, yy, 5.8, 0.5, i % 2 === 0 ? C.lightbg : C.deep);
    s.addText(t.leads, { x: 0.45, y: yy + 0.1, w: 1.6, h: 0.3, fontSize: 11.5, color: t.color, bold: true, margin: 0 });
    s.addText(t.wall,  { x: 2.15, y: yy + 0.1, w: 1.7, h: 0.3, fontSize: 11.5, color: C.white, margin: 0 });
    s.addText(t.artery,{ x: 3.95, y: yy + 0.1, w: 1.9, h: 0.3, fontSize: 11.5, color: C.grey,  margin: 0 });
  });

  // Reciprocal changes note
  card(s, 0.35, 6.38, 5.8, 0.72, "1A0810");
  s.addText("⚡ Reciprocal changes: ST depression in leads 'opposite' the infarcted wall — confirms STEMI and excludes pericarditis", {
    x: 0.55, y: 6.45, w: 5.5, h: 0.6, fontSize: 12, color: C.yellow, wrap: true, margin: 0
  });

  if (fetchedImages.stemi_ant) {
    s.addImage({ data: fetchedImages.stemi_ant, x: 6.5, y: 1.0, w: 6.5, h: 6.3 });
    s.addText("Anterolateral STEMI — ST elevation V1–V6, I, aVL  with reciprocal changes II, III, aVF", {
      x: 6.5, y: 7.35, w: 6.5, h: 0.12, fontSize: 9.5, color: C.grey, italic: true, align: "center", margin: 0
    });
  }
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 11 – Other Arrhythmias (SVT, Sinus Brady/Tachy)
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.teal);
  slideTitle(s, "Common Arrhythmias — Quick Reference");

  const arrs = [
    {
      name: "Sinus Tachycardia",
      color: C.yellow,
      features: ["Rate: 100–180 bpm", "Normal P-QRS-T morphology", "Every P followed by QRS", "Causes: pain, fever, anaemia, thyrotoxicosis, PE, anxiety"]
    },
    {
      name: "Sinus Bradycardia",
      color: C.green,
      features: ["Rate: < 60 bpm", "Normal P-QRS-T morphology", "Regular rhythm", "Causes: athletes, hypothyroidism, beta-blockers, vasovagal, IHD"]
    },
    {
      name: "SVT (Narrow complex tachycardia)",
      color: C.teal,
      features: ["Rate: 150–250 bpm", "Regular narrow QRS", "P waves buried in / after QRS", "Types: AVNRT (most common), AVRT, AT"]
    },
    {
      name: "Atrial Flutter",
      color: C.yellow,
      features: ["Atrial rate ~300 bpm", "Sawtooth 'flutter' waves — best in II, III, aVF, V1", "2:1 conduction → ventricular rate ~150 bpm", "Regular rhythm unless variable block"]
    },
    {
      name: "Ventricular Fibrillation (VF)",
      color: C.red,
      features: ["Chaotic, irregular undulations", "No discernible QRS complexes", "Cardiac arrest — pulseless", "Immediate unsynchronised DC shock required"]
    },
    {
      name: "WPW (Wolf-Parkinson-White)",
      color: C.teal,
      features: ["Short PR interval < 0.12 sec", "Delta wave (slurred QRS upstroke)", "Wide QRS", "Risk of rapid AF via accessory pathway → VF"]
    },
  ];

  const cw = 4.2, ch = 2.2, startX = 0.3, startY = 1.05, gapX = 0.15, gapY = 0.15;
  arrs.forEach((a, i) => {
    const col = i % 3, row = Math.floor(i / 3);
    const x = startX + col * (cw + gapX);
    const y = startY + row * (ch + gapY);
    card(s, x, y, cw, ch, C.lightbg);
    s.addShape("rect", { x, y, w: cw, h: 0.35, fill: { color: a.color }, line: { type: "none" } });
    s.addText(a.name, { x: x + 0.12, y: y + 0.03, w: cw - 0.2, h: 0.28, fontSize: 11.5, bold: true, color: C.navy, margin: 0 });
    a.features.forEach((f, j) => {
      s.addText("• " + f, { x: x + 0.15, y: y + 0.43 + j * 0.43, w: cw - 0.25, h: 0.38, fontSize: 11, color: C.white, wrap: true, margin: 0 });
    });
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 12 – Bundle Branch Blocks
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.yellow);
  slideTitle(s, "Bundle Branch Blocks (BBB)", C.yellow);

  // RBBB
  card(s, 0.35, 1.0, 6.1, 5.7, C.lightbg);
  s.addShape("rect", { x: 0.35, y: 1.0, w: 6.1, h: 0.4, fill: { color: C.teal }, line: { type: "none" } });
  s.addText("RIGHT BUNDLE BRANCH BLOCK (RBBB)", { x: 0.5, y: 1.05, w: 5.8, h: 0.3, fontSize: 13, bold: true, color: C.navy, margin: 0 });
  const rbbbFeats = [
    "QRS duration ≥ 0.12 sec (3 small boxes)",
    "RSR' pattern in V1 ('M' shaped / 'rabbit ears')",
    "Wide S wave in I, V5, V6",
    "Secondary ST-T changes in V1-V2",
    "Incomplete RBBB: QRS 0.10–0.12 sec + RSR'",
    "Causes: RVH, PE, anterior MI, ASD, normal variant",
  ];
  rbbbFeats.forEach((f, i) => {
    const yy = 1.52 + i * 0.62;
    card(s, 0.5, yy, 5.8, 0.55, i % 2 === 0 ? C.deep : C.lightbg);
    s.addText("• " + f, { x: 0.65, y: yy + 0.1, w: 5.5, h: 0.35, fontSize: 12.5, color: C.white, margin: 0, wrap: true });
  });
  card(s, 0.5, 5.38, 5.8, 1.0, "0D2137");
  s.addText("Mnemonic: 'MaRRoW' — RBBB has M in V1, W in V6\n'WiLLiaM' — LBBB has W in V1, M in V6", {
    x: 0.65, y: 5.48, w: 5.5, h: 0.85, fontSize: 13, color: C.yellow, italic: true, bold: true, wrap: true, margin: 0
  });

  // LBBB
  card(s, 6.75, 1.0, 6.2, 5.7, C.lightbg);
  s.addShape("rect", { x: 6.75, y: 1.0, w: 6.2, h: 0.4, fill: { color: C.red }, line: { type: "none" } });
  s.addText("LEFT BUNDLE BRANCH BLOCK (LBBB)", { x: 6.9, y: 1.05, w: 5.9, h: 0.3, fontSize: 13, bold: true, color: C.white, margin: 0 });
  const lbbbFeats = [
    "QRS duration ≥ 0.12 sec",
    "Broad, notched ('M') R wave in I, V5, V6",
    "Deep QS or rS in V1",
    "No septal Q in I, V5, V6",
    "Secondary ST-T changes (discordant)",
    "NEW LBBB + chest pain = STEMI equivalent",
  ];
  lbbbFeats.forEach((f, i) => {
    const yy = 1.52 + i * 0.62;
    const bg = i === 5 ? "2D0A0E" : (i % 2 === 0 ? C.deep : C.lightbg);
    card(s, 6.9, yy, 5.9, 0.55, bg);
    s.addText("• " + f, { x: 7.05, y: yy + 0.1, w: 5.6, h: 0.35, fontSize: 12.5, color: i === 5 ? C.red : C.white, bold: i === 5, margin: 0, wrap: true });
  });
  card(s, 6.9, 5.38, 5.9, 1.0, "0D2137");
  s.addText("'WiLLiaM MaRRoW' — this mnemonic covers both blocks simultaneously.\nLBBB masks ischaemia — use Sgarbossa criteria to detect MI behind LBBB.", {
    x: 7.05, y: 5.48, w: 5.7, h: 0.85, fontSize: 12, color: C.yellow, italic: true, wrap: true, margin: 0
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 13 – Electrolyte & Other ECG Changes
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.teal);
  slideTitle(s, "ECG Changes in Electrolyte Disorders & Special Patterns");

  const items = [
    {
      title: "Hyperkalaemia (High K⁺)",
      color: C.red,
      x: 0.35, y: 1.05, w: 6.1, h: 2.5,
      pts: ["K⁺ 5.5–6.0: Peaked ('tent') T waves (earliest sign)", "K⁺ 6.0–7.0: Flat P waves, wide QRS", "K⁺ 7.0–8.0: Sine-wave pattern", "K⁺ >8.0: VF / asystole"],
    },
    {
      title: "Hypokalaemia (Low K⁺)",
      color: C.green,
      x: 6.75, y: 1.05, w: 6.2, h: 2.5,
      pts: ["Flat or inverted T waves", "Prominent U wave (after T wave)", "U wave > T wave amplitude", "Prolonged QU interval, risk of torsades"],
    },
    {
      title: "Hypercalcaemia",
      color: C.yellow,
      x: 0.35, y: 3.65, w: 6.1, h: 1.8,
      pts: ["Shortened QT interval", "Short ST segment / absent ST", "Bradycardia in severe cases"],
    },
    {
      title: "Hypocalcaemia",
      color: C.teal,
      x: 6.75, y: 3.65, w: 6.2, h: 1.8,
      pts: ["Prolonged QT interval (QTc >440 ms)", "Flat T waves", "Risk of torsades de pointes"],
    },
    {
      title: "Pericarditis",
      color: C.yellow,
      x: 0.35, y: 5.55, w: 6.1, h: 1.65,
      pts: ["Diffuse (saddle-shaped) ST elevation — all leads", "PR depression (especially aVR: PR elevation)", "No reciprocal changes (unlike STEMI)", "Evolves over hours-days"],
    },
    {
      title: "Pulmonary Embolism (PE)",
      color: C.red,
      x: 6.75, y: 5.55, w: 6.2, h: 1.65,
      pts: ["Sinus tachycardia (most common)", "S1Q3T3 pattern (S in I, Q in III, inverted T in III)", "RBBB (right heart strain)", "T-wave inversions V1–V4"],
    },
  ];

  items.forEach(item => {
    card(s, item.x, item.y, item.w, item.h, C.lightbg);
    s.addShape("rect", { x: item.x, y: item.y, w: item.w, h: 0.35, fill: { color: item.color }, line: { type: "none" } });
    s.addText(item.title, { x: item.x + 0.15, y: item.y + 0.04, w: item.w - 0.2, h: 0.28, fontSize: 12.5, bold: true, color: C.navy, margin: 0 });
    item.pts.forEach((p, j) => {
      s.addText("• " + p, { x: item.x + 0.2, y: item.y + 0.45 + j * 0.43, w: item.w - 0.3, h: 0.4, fontSize: 12, color: C.white, wrap: true, margin: 0 });
    });
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 14 – Quick Reference Summary
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  accentBar(s, C.teal);
  slideTitle(s, "Quick Reference — ECG at a Glance");

  const rows2 = [
    ["Finding",                  "Think of...",                          "Key Diagnostic Feature"],
    ["Wide QRS + tachycardia",   "VT vs SVT with aberrancy",             "AV dissociation, fusion beats → VT"],
    ["Irregularly irregular",    "Atrial fibrillation",                  "No P waves, fibrillatory baseline"],
    ["Sawtooth flutter waves",   "Atrial flutter",                       "~300/min atrial rate, 2:1 conduction"],
    ["ST elevation",             "STEMI / pericarditis / Brugada",       "Contiguous leads + reciprocal = STEMI"],
    ["ST depression",            "Ischaemia / NSTEMI / digoxin",         "Horizontal/downsloping = ischaemia"],
    ["Prolonged PR",             "1st degree AV block",                  "PR > 0.20 sec, all QRS present"],
    ["Dropped QRS",              "2nd degree AV block",                  "Mobitz I (PR ↑) vs Mobitz II (constant PR)"],
    ["P-QRS dissociation",       "3rd degree / complete heart block",    "P rate ≠ QRS rate, independent"],
    ["Peaked T waves",           "Hyperkalaemia",                        "Symmetric, narrow peak — earliest sign"],
    ["Prominent U wave",         "Hypokalaemia",                         "U > T wave, prolonged QU"],
    ["Delta wave + short PR",    "WPW / pre-excitation",                 "Slurred QRS upstroke, risk AF→VF"],
    ["S1Q3T3 + sinus tachy",     "Pulmonary embolism",                   "RV strain pattern, RBBB possible"],
  ];

  const colWidths = [3.2, 3.8, 5.5];
  const colX = [0.35, 3.65, 7.55];
  const headerColors = [C.teal, C.teal, C.teal];

  rows2.forEach((row, ri) => {
    const yy = 1.0 + ri * 0.48;
    const isHeader = ri === 0;
    const bg = isHeader ? "0D2137" : (ri % 2 === 0 ? C.lightbg : C.deep);
    card(s, 0.35, yy, 12.6, 0.44, bg);
    row.forEach((cell, ci) => {
      s.addText(cell, {
        x: colX[ci] + 0.1, y: yy + 0.07, w: colWidths[ci] - 0.15, h: 0.3,
        fontSize: isHeader ? 12.5 : 11.5,
        bold: isHeader || ci === 0,
        color: isHeader ? C.teal : (ci === 0 ? C.yellow : (ci === 1 ? C.white : C.grey)),
        margin: 0, wrap: true
      });
    });
  });
}

// ════════════════════════════════════════════════════════════════════════════
// SLIDE 15 – Thank You / Approach Flowchart
// ════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  darkBg(s);
  s.addShape("rect", { x: 0, y: 0, w: 13.3, h: 0.12, fill: { color: C.teal }, line: { type: "none" } });
  s.addShape("rect", { x: 0, y: 7.38, w: 13.3, h: 0.12, fill: { color: C.teal }, line: { type: "none" } });

  s.addText("ECG INTERPRETATION FLOWCHART", {
    x: 0.5, y: 0.25, w: 12, h: 0.5, fontSize: 18, bold: true, color: C.teal, align: "center", charSpacing: 4, margin: 0
  });

  const steps2 = [
    { label: "1. RATE", sub: "< 60 Brady  |  60–100 Normal  |  >100 Tachy", color: C.teal },
    { label: "2. RHYTHM", sub: "Regular? Irregular? Irregularly irregular?", color: C.green },
    { label: "3. P WAVES", sub: "Present, upright, 1:1?", color: C.yellow },
    { label: "4. PR INTERVAL", sub: "Normal 0.12–0.20 s", color: C.teal },
    { label: "5. QRS", sub: "Narrow < 0.12 s  vs  Wide ≥ 0.12 s", color: C.yellow },
    { label: "6. ST/T", sub: "Elevation / depression / T inversion", color: C.red },
    { label: "7. QTc", sub: "< 440 ms (men) / < 460 ms (women)", color: C.teal },
    { label: "8. CLINICAL CONTEXT", sub: "Symptoms + history + previous ECG", color: C.green },
  ];

  steps2.forEach((st, i) => {
    const col = i % 4, row = Math.floor(i / 4);
    const x = 0.35 + col * 3.25;
    const y = 0.98 + row * 3.05;
    const w2 = 3.0, h2 = 2.85;
    card(s, x, y, w2, h2, C.lightbg);
    s.addShape("ellipse", { x: x + w2/2 - 0.5, y: y + 0.2, w: 1.0, h: 1.0, fill: { color: st.color }, line: { type: "none" } });
    s.addText(st.label, { x: x + w2/2 - 0.5, y: y + 0.2, w: 1.0, h: 1.0, fontSize: 11, bold: true, color: C.navy, align: "center", valign: "middle", margin: 0, wrap: true });
    s.addText(st.sub, { x: x + 0.15, y: y + 1.35, w: w2 - 0.25, h: 1.35, fontSize: 11.5, color: C.white, align: "center", wrap: true, margin: 0 });
  });

  s.addText("Master the systematic approach — every ECG, every time.", {
    x: 0.5, y: 7.15, w: 12, h: 0.2, fontSize: 13, color: C.grey, italic: true, align: "center", margin: 0
  });
}

// ─── Write file ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/ecg-slides/ECG_Medical_Student_Guide.pptx" })
  .then(() => console.log("✅ Presentation saved!"))
  .catch(e => console.error("Error:", e));