It is a concern, unless you really think that everyone who buys high-end video cards also likes big, bulky cases. There are a lot of smaller cases that are quite popular amongst enthusiast and that won't have enough room for such a card. Antec Sonata and P160, Coolermaster Mystique adn some Centurion (5 is ok, 534 not), Thermaltake Tsunami and Soprano spring to mind. And even with some of the bigger cases you'll still lose 2 hard drive slots.meh, not exactly a concern, this isn't a mid-range card afterall.
Edit:
Won't even fit in an Antec P180...
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