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The Cataclysm
I'm still not sure who is the true end boss of Cataclysm is, but the cataclysm appears to have been caused by attempts to incantation to summon extremely powerful beings using an ancient incantation by Deathwing and Azshara. They're both very powerful, but the cataclysm itself suggests something more powerful is behind it, perhaps their shared past of Old God influence?
The Guardian of Tirisfal
Malfurion Stormrage will be returning to Azeroth to aid in the creation of the new Guardian of Tirisfal - Thrall! Med'an's role in these events is currently unknown.
The New (New) Horde
Thrall will hand over the leadership of the Horde to Garrosh Hellscream, while he serves as a coordinator for both the Horde and Alliance forces in and effort to combat the new threat of the Naga and Black Dragonflight. Without Thrall to keep Garrosh in check, he declares open war on the Alliance. In the political upheaval Cairne Bloodhoof is implicated as a traitor to the Horde and murdered by Garrosh. Cairne's son Baine takes over as the new Tauren chieftan. This could explain why Baine was removed from the game in Patch 3.2.2, you can find more information about this in Ahmo Thunderhorn - replacement for Baine Bloodhoof?
