How much graphics horsepower do you need? A few companies make Radeon 7750s in fanless configurations and I typically buy Radeon 6450s to get simple multiple monitor support on office machines.
I have a Radon 5750 that has about 1lb. of heat sink on it and I'm just going to say that it gets hot enough just decoding HD video that I'm glad I've never used it for gaming.
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