Putting a fan on even the stock heatsink of a video card provides dramitic results. If your looking for extreme air cooling for a video card you can buy heatsinks that wrap the whole card. Thermaltake makes one (must say one of their last very good products) and I think swifttech or someone else makes one two. Or you can always go the peltier or water cooling route. But to answer your question, yes it is worth putting a cheap fan on the heatsink on your video card.
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