I also have a similar problem.
I'm not sure if it's the fan or the hard drive, I think it's the fan.
You can hear here... it's sounds pretty awful,
http://soundcloud.com/rob-tierney/this-is-what-my-mac-sounds
I have dropped my mac... so I guessing it's some sort of mechanical problem?
A few months ago, I also installed smcFanControl.... as my mac was running very hot... could this have caused the problem?
I also upgraded my hard drive to a Western Digital Scorpio Black WD5000BEKT 500GB, and upgraded the ram to, 8gb, CORSAIR 8GB (2 x 4GB) 204-Pin DDR3 SO-DIMM DDR3 1066
I'm living in China now, so, no access to mac store.
Should I just try replacing the fan? I can buy one online.
@throAU... could it be the heat sensor? If so, is this a big problem?
Cheers