What I did with my 5600XT (annoying tiny little heatsink with fan) was to
scavenge an old CPU heatsink (specifically a Taisol 733000 series, from my old
Duron 750), and bond it on top. I applied JB Weld cos I had no proper thermal
epoxy, and didn't want to spend $15 on a product I'd only need once, however a
real thermal epoxy's better I'm certain.
The heatsink blocks two PCI slots, and gets moderately warm in normal
operation. In typical desktop role and occasional leave-it-on-all-night sessions, it
hasn't failed afaict.
I also don't do extensive 3D. The Duron 1.6 takes care of that concern. :)
There are definitely VGA sinks designed for video cards, and I've seen
fanless 5200s, so it's another option-- they sometimes sell them for the silent
computing market.
If you don't mind the fan noise, also check with the maker of the card;
sometimes they have lifetime warranties which cover the cooler.
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