A myocardial bridge is an anatomical anomaly in which an epicardial coronary artery becomes engulfed in a limited segment by myocardial fibers. Myocardial ischemia, infarction and sudden death can occur some patients with a myocardial bridge. However, the clinical course can be worse if pheochromocytoma coexists with a myocardial bridge. We experienced anesthetic management of a 52-year-old female patient with a history of myocardial infarction associated with a myocardial bridge and pheochromocytoma. The goal of anesthesia is to avoid hypertension and tachycardia. Nitroglycerin, as a coronary vasodilator, can aggravate the degree of systolic narrowing of the coronary artery. This finding appears to conflict with ordinary management for cardiac ischemia.