I have a reference design R9 290, and we all know what it sounds like. Under Ashes of the Singularity, in these hot summer days, the fan ran at around 90% with the GPU being 90°C, and it sounded like a leaf blower.
Also I have a 450W PSU, and, with the GPU paired with an OC'd 4790K, I'm really living on the edge not frying the PSU.