Are you sure that the fan on the card isn't 'dying'?
Have a good look at in operation. It's not enough to simply see the thing spinning. BE sure that it's actually spinning at the correct speed, and not visibly slowing down during use.
Alternatively, the thermal paste between graphics processor and heatsink may be in need of replacement. That's a rather tricky job, so it might be one for a technician if you are not familiar with the task.
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Grandad
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since Mar 2004