Hypovolemic Shock: Given the low blood pressure (70/50 mmHg), tachycardia (HR 132/min), and elevated CVP (4-5 cm) in a chronic alcoholic, hypovolemic shock due to dehydration or gastrointestinal bleeding is a strong consideration. The absence of signs of distributive shock (e.g., warm extremities) and cardiogenic shock (e.g., signs of heart failure) makes this more likely.

Cardiogenic Shock: Although there are no signs of heart failure mentioned, cardiogenic shock cannot be ruled out entirely, especially in a chronic alcoholic who may have underlying cardiomyopathy. The elevated CVP could suggest right ventricular failure.
Septic Shock: Despite the absence of specific signs of infection, septic shock is a consideration in any critically ill patient, especially if there's a potential source of infection. Chronic alcoholics are at increased risk of infections.
Toxic or Metabolic Causes: Alcohol withdrawal or other toxic ingestions could lead to hypotension and tachycardia, though the direct connection to the provided vital signs is less clear without additional symptoms.

Cardiac Tamponade: Although less likely given the clinical presentation, cardiac tamponade can cause hypotension, tachycardia, and elevated CVP. It's a diagnosis that would be catastrophic if missed.
Pulmonary Embolism: This could cause hypotension, tachycardia, and elevated CVP, especially if it's a large PE causing right ventricular strain. It's less likely given the context but critical not to miss.
Adrenal Insufficiency: In a chronic alcoholic with hypotension, adrenal insufficiency should be considered, as alcoholics are at risk of adrenal dysfunction.

Neurogenic Shock: Typically presents with hypotension and bradycardia, but in some cases, especially early on, tachycardia can be seen. It's less likely given the context but should be considered if there's a history of spinal cord injury or other neurological insult.
Anaphylactic Shock: Presents with hypotension, tachycardia, and often signs of allergic reaction. It's rare but would be a critical diagnosis to identify due to its rapid progression and high mortality if untreated.

Treatment should be guided by the underlying cause but generally includes:

Fluid resuscitation for hypovolemic shock
Vasopressors for refractory hypotension
Addressing the underlying cause (e.g., stopping bleeding, treating infection, managing cardiac issues)
Supportive care (e.g., oxygen, monitoring)