Quote Originally Posted by DarkDisciple View Post
Side fan blows in general direction of memory / behind heatsink fan. Fan on heatsink blows towards back of case and standard exhaust fan there. PSU fan also pulls air out from above the heatsink.

I have reinstalled it twice now with varying ammounts of thermal compound, and temps remain ~ the same. I am using the metal bracket behind the mobo to secure it, as opposed to the push pins. It feels like it is on there securely, and looks to be lined up correctly.

It does seem possible that their is something wrong with heatsink install, i just can't figure what. Even when the cpu is at 60 degrees, the top of the heatsink is cool / room temperature to the touch.
post some pictures of your setup maybe we missed something.