My biggest gripe about the blizppc is that the CPUs sit on the 'outside' of the card - ie towards the side panel.
This means I have no room to fan them directly in my tower, so even my 040 is passively cooled with a (fairly chunky) heatsink. It actually touches the side panel in my case - however, that does tend to give me a rather large passive cooling surface ;-)
I really need to find some more of those really low profile 486 fan heatsink combos...