This was my solution to my video card(s) not breathing:
Note: Pics are of my wife's computer, but our builds are similar and use the same case. I'm using a Noctua cooler on the i5 in my main rig, but the Intel cooler is effectively silent on her i3 so I saw no point in installing my spare Hyper 212 and making the case harder to work in.
Originally I had a PSU with an 80mm fan, which drew air from behind the video card and exhausted at the bottom of the case, providing at least some ventilation. I couldn't resist a pair of Sparkle Platinum PSUs a few weeks ago for ~$25 each though, and this effectively turned the top of the case into a dead-zone as these PSUs draw air from next to the CPU, and there is no vent or mesh at the top of the case. Under Furmark, the cards didn't throttle, but I was uncomfortable with 80-90c and it was causing the fans to get a bit noisy under extended gaming.
One of the side panels for the case has a mesh - this I moved to the backside, and cut out a space for a Noctua 80mm fan that I had laying around in the non-mesh panel. Case pressure is slightly positive, causing airflow over the top of the card and out the mesh on the other side. Even running at only 25-35% speed, the 80mm fan provides sufficient fresh air to the top of the case, and dropped GPU temperatures under Furmark almost 20c while simultaneously reducing noise. Under normal gaming conditions they're near-silent, with the power supply fan and my external hard drive being the noisiest components. Two more Noctua fans are now on my wishlist for the PSUs.