Most of them dump heat in the case. This is not really a problem unless you have more than one gpu. When you have two dumping heat and no easy way to exhaust it then you get the problems you mention.
You can get models which dump 95% of the heat out the rear. These are ideal for multi gpu solutions, but they often come with other drawbacks such as increased noise over dual fan solutions and worse gpu cooling performance.
Blowers don't require side fans usually, but it can still help. Cards that dump heat in the case often benefit from side exhaust fans greatly.
Blower type fans below. Have one fan and an enclosed shroud to ensure most of the heat stays within the card shroud and is exhausted out the rear through the vents.
This makes a lot more sense now, cheers. Admittedly I am now debating whether or not the Corsair Carbide 540 is the right case for me to treat myself to...