Replacing the heatsink will be tough. nForce 3/4 chips are usually located under the video card (PCI-E or AGP) which rules out virtually every aftermarket cooler. I tried to replace the noisy cooler on my Gigabyte GA-K8NS Ultra-939, and I ended up using a trimmed passive Zalman cooler. No problems so far, and it fits (barely)below/beside my X800XT AIW.
You could try a Zalman FB123 (
http://www.zalmanusa.com/usa/product/view.asp?idx=15&code=016 ) and have it blow down on the nForce4 chipset. It might help.
It would be nice though if someone (consider this an open invitation Zalman, Thermalright, Thermaltake, Swiftech, etc...) would create a good aftermarket cooler for nForce3/4 chips.
Good luck