When you stand still in a room, and you haven't encountered any necromorphs for at least ten minutes or so, and all you hear is the slow paced breathing, and his heartbeat? Epic. You slowly ease on the stick so he moves /slowly/ forward into this dark, unfamiliar room. You begin to move around corners with weapon /always/ drawn. You listen for sounds that are not you. You hear a sound that is part of the operation of the ship. At least that's what you think it is.
(There's one fucker that I think is programmed to only move when there is a loud noise, as long as you don't see him.)
The game controls are adequate. The game doesn't add anything new, but it is a deep involving experience. Play this game for one hour and tell me that you are not stomping every single god damned corpse in the game into PIECES before you leave it. Not out of metagaming, or spite. But out of fear [spoiler]for those fuckers who infest the dead[/spoiler].
This game deserves some kind of award for audio-engineering. Seriously. If you aren't playing this with 5.1 or 5.1 headphones, you're missing out a good chunk of the experience.