More people than ever have the condition, in which the heart muscle struggles to pump enough blood around the body, but the number of nurses looking after sufferers has been cut.
The British Heart Foundation Scotland and Chest Heart and Stroke Scotland are raising concern that some patients may miss out on vital support unless the situation improves.
Almost 94,000 people in Scotland have heart failure, but exercise programmes and careful self-management are known to make a significant difference.
Heart failure nurses have been shown to save the NHS around £1826 per patient, due to a 35% cut in hospital admissions.
The two charities funded a review of heart failure nurses north of the Border in 2008 and 2012. This shows a 7% drop in the numbers across Scotland over the four years.
The number of nurses working across Scotland is 10% below the minimum of one nurse for every 100,000 people, recommended in national guidelines drawn up by Scottish experts.
Suzanne Bell, chair of the Scottish Heart Failure Nurse Forum, said: "Specialist heart failure nurses have the skills, training and expertise to manage the complexities of this condition, in a highly cost-effective way. Despite this, NHS boards are failing to make enough provision."
Marjory Burns, director of BHF Scotland, said: "NHS boards need to up their game and make the provision of these crucial services a top priority."
A Scottish Government spokesperson said: "Tackling heart disease is a national clinical priority for Scotland."
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