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Cardiogenic pulmonary edema primarily arises from left-sided heart failure. In this condition, the left ventricle is unable to effectively pump blood out to the body, leading to increased pressure in the left atrium and subsequently in the pulmonary veins. This increased pressure causes fluid to leak from the capillaries into the alveoli of the lungs, resulting in pulmonary edema. The accumulation of fluid in the lungs impairs gas exchange, leading to symptoms such as shortness of breath and difficulty breathing.

While right-sided heart failure, fluid overload, and pneumonia can also affect fluid status and lung function, they do not primarily lead to cardiogenic pulmonary edema. Right-sided heart failure typically results in fluid accumulation in the systemic circulation rather than the lungs. Fluid overload can contribute to pulmonary edema, but it is often a consequence of conditions such as heart failure rather than a primary cause. Pneumonia involves infection and inflammation within the lung tissue, leading to fluid retention, but it is distinct from the pathophysiology of cardiogenic pulmonary edema related to heart failure.