OCUK tested the 290X with the god-king of air coolers installed. Temperatures were down by well over 30C, at essentially inaudible volumes. It's proof that the problems with the card aren't inherent to the chip itself, certainly, but also shows how much they cheaped out on the cooling.
It's ridiculous that with a 'reasonable' fan speed setting, the card with a stock cooler throttles down to ~850MHz. It's ridiculous that at those clocks, it beats Titan anyway. It's ridiculous that *overclocked* to 1100MHz, the custom cooler can keep the card stable at 62C. So oddly enough, in damning AMD for their silly decisionmaking here, we end up being even more amazed at the potential performance of this beast, which lest we forget together with its little brother and the 7950, renders the entire nVidia lineup pointless.
Another point though: factory coolers still aren't anywhere near as good as the best self-installed one. I bought an MSI Twin Frozr 3 version of the 7950, but I needn't have bothered - the noise was unacceptable regardless and I was forced to install Arctic Cooling's cooler (which is fantastic). Only cost me $10-20 more than the stock model though, so not that annoyed, and. (And besides, it meant getting a 7970 circuit board instead of a 7950 one: not particularly useful, but better is better) But I digress, I just mean to say that unless you're familiar with and are satisfied at the noise level of previous factory custom cards, it may be an idea to just buy now and install your own solution down the line, which will be better but probably $30-60 more expensive.