High end graphics cards usually come with a stock cooler design that is capable of handling the sort of heat the monsters put out, unfortunately they only do enough to maintain GPUs at a safe operating temperature.
Hardware Canucks has a look at the Sapphire Radeon HD 4890 2GB Vapor-X video card. It sports an insanely beefy cooling system that should keep things a bit quiet and running cooler:
Sapphire’s HD 4890 2GB Vapor-X has a unique design with a partial-length heatsink covering the area directly above the core and making its way towards the backplate. Meanwhile, the rear portion of the card has a separate heatsink which is used to cool off the hot running VRMs. Its blue PCB makes the whole affair look faintly Gigabyte-esque while the length sticks to the reference 9.5”.
Beefy and svelte, interesting combination they have going on there.

