Dent in heatsink base

I ask because I have one fitted to my old AMD Dual Core rig, and the only way I can have it seated is with the fan facing my GFX card

Haveing your TRUE with the air flow vertical and heatpipes right and left is the better way - check out some of the reviews that mount the TRUE and MegaH in both directions.

Just like Prolimatech Megahalems, both Ultra-120 eXtreme coolers proved more efficient when they were installed with the heatpipes going across the processor heat-spreader
Prolimatech Megahalems and 12 Other Coolers for Intel Core i7 Overclocking (page 7) xbit labs
This is with a antec 1200 btw with a bottom mounted psu but roof mounted fans
 
Mate.where is the fan from the PSU?I have the same PSU only the 500 Watts one and its fan is facing the vid card and it really helps it coolI know that because putted my hand above the fan and its blowing cool air directly onto the card.And my HD4870 is staying idle at 55 degrees and if I block put something on top of the PSU fan the card gets to 58 degress.

It's underneath, facing the bottom vent. Depends if your case has a bottom vent or not I suppose. My 4870 is currently idling at 48c.
I first installed it like you with fan facing into case, and was advised to reverse it. I'm presuming I have optimal psu air intake this way around now.
 
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