(disclaimer: AIM judge review here! these are just my opinions and thoughts, you can take from them whatever you like! music is subjective and all that. <3)
i love the slow buildup of the ambience into groove during the first minute; it all feels very Metroid which is honestly one of the first things i thought about when i saw the artwork you chose as inspiration. the vocal over the top of the heartbeat rhythm and all the other sfx are super atmospheric. great horror soundtracking, it's uneasy and murky and there's still underlying beats to discover through the murk. some of the parts feel like they wander around the same sort of space when they could have more of a direction, like both the different guitar-ish sounds (one prior to the vocal clip and the distorted one later on) and the high synth plucks, which also feel like they're played weirdly straight amidst a sea of cool ambient textures. i wonder if just a bit more focus would make the parts more recognizable, but i do also think it's cool that it's sorta wandering, ambiguous, nebulous... in a way it contributes to the mood too, so make of that thought what you will. : )