I recomend doing a 5 camp clear taking 2 points Q instead of E, I am aware that you wont have E for scuttle but 2 points Q makes your clear faster as often times I don't use e on camps

Your Q its enemys twice, which is awesome if you go phase rush as all u need is one AA or e and a Q to proc

Conquerer with domination
This is my prefered page and is the best in my opinion, I will try phase rush in the new season with the new items and see if its good so look forward to that.

Starter Items
I prefer red smite over blue, I am aware that blue smite gives movement speed when activated but i like the extra damage I can have with red, but this is a personal preference, just use whatever you want

Core
Triforce= Triforce is the first item you want to get as hecarim benefits from all its stats
Ravenous Hydra= The omnivape on this item is insane, I recomend picking it up
Deaths Dance= Deaths Dance is really strong on hecarim, with this and ravenous you should be healing an insane amount

Situational
Spirit Visage= Spirit Visage is OP with this set up as it increases all healing from all source, although if the enemy is full ad I dont recomend, if there mixed you can pick this up with a dead mans as your last items
Dead Mans= This item is pretty strong on heca, i recomend it if either the enemy is full ad OR mixed in which case get spirit then dead mans
Black Cleaver= Pretty good, get this if enemy has 2+ tanks
Randuins Omen= If the enemy has 2+ crit champs get this, also has a nice slow
Chempunk chainsword= Get executioners after triforce if healer, then upgrade to this as last item