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My PNY Ti4200 card developed a very similar problem after a few months of use. The fan was still working, but the card finally got so hot the capacitors started to bulge.
I finally had to RMA the card. Unfortunately, they're getting so many returns on the Ti 4200's (and 4400's) that they have been back ordered for over a month.
Eventually, I bought a new ATI card, 'cause I couldn't wait any longer. I'll probably just sell the Ti4200 if & when they ever send me a new one.
Good luck with your card, but chances are, you'll have to RMA it eventually.
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