Soldato
I tried tweaking my reference Vega 64 and was unable to get the noise to an acceptable level under load, Within 10 minutes of gaming it would turn into a hairdryer and that was in a Corsair M-ATX cube case, With an ITX case it'd be even worse.
The only way to keep the noise down at load would be to throttle it's performance and if you're doing that why waste money on a Vega card? You may as well save a couple of hundred quid and buy a Polaris card instead.
Well I defo not having the same experience has yourself with my VEGA. My GPU is in a decent size case mind you so maybe the extra space airflow is helping mine.